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Crigler Technique For Congenital Nasolacrimal Duct Obstruction

Abstract
Congenital nasolacrimal duct obstruction (CNLDO) is defined as the failure of drainage of tears down the nasolacrimal system in the neonatal age group. It results in tearing, which is termed "epiphora." The prevalence of CNLDO is between 5% and 20%.[1][2] A comprehensive study of 4792 infants in Great Britain showed that the prevalence of epiphora in the first year of life was 20%, with 95% of these showing symptoms at one month of age.[1] There is a higher prevalence of CNLDO in premature infants.[3] CNLDO presents bilaterally in 14% to 34% of cases.[4] It has also been shown that anisometropic amblyopia may occur in 10% to 12% of children with CLNDO, so a proper ophthalmic eye examination and cycloplegic refraction are performed in all cases with a careful subsequent follow-up for three to four years.[5][6] Of interest is the finding of Cassidy in 1952, who noted that there was obstruction of the nasolacrimal duct in 13 of 15 stillborn infants. His postulation that patency of the nasolacrimal duct occurs within the first few days to weeks after birth is a reasonable one.[7] Children most often present within a few months of birth with epiphora and sometimes mucoid discharge from one or both sides. However, even with symptoms present since birth, patients may present when several years old. Other causes of epiphora in children like epiblepharon, congenital glaucoma, foreign body, corneal infections, and corneal dystrophies need to be excluded. Wheres the Jones 1 test where insertion of fluorescein dye into the eye is followed by the presence of dye in the nose after 5 minutes may be used, it is rarely used now since the clinical history and observation of the tearing, and mucoid discharge generally confirms the diagnosis. Similarly, the dye disappearance test over 5 minutes may also be used, but there may be significant false positive and negative results in infants. 

Publisher

StatPearls Publishing
Treasure Island (FL)

Language

eng

PubMed ID

32644693

Citation

Hu K, Patel J, Patel BC: Crigler Technique for Congenital Nasolacrimal Duct Obstruction. StatPearls. StatPearls Publishing, 2020, Treasure Island (FL).
Hu K, Patel J, Patel BC. Crigler Technique For Congenital Nasolacrimal Duct Obstruction. StatPearls. StatPearls Publishing; 2020.
Hu K & Patel J & Patel BC. (2020). Crigler Technique For Congenital Nasolacrimal Duct Obstruction. In StatPearls. Treasure Island (FL): StatPearls Publishing
Hu K, Patel J, Patel BC. Crigler Technique for Congenital Nasolacrimal Duct Obstruction. StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.
* Article titles in AMA citation format should be in sentence-case
TY - CHAP T1 - Crigler Technique For Congenital Nasolacrimal Duct Obstruction BT - StatPearls A1 - Hu,Katherine, AU - Patel,Jay, AU - Patel,Bhupendra C., Y1 - 2020/01// PY - 2020/7/10/pubmed PY - 2020/7/10/medline PY - 2020/7/10/entrez N2 - Congenital nasolacrimal duct obstruction (CNLDO) is defined as the failure of drainage of tears down the nasolacrimal system in the neonatal age group. It results in tearing, which is termed "epiphora." The prevalence of CNLDO is between 5% and 20%.[1][2] A comprehensive study of 4792 infants in Great Britain showed that the prevalence of epiphora in the first year of life was 20%, with 95% of these showing symptoms at one month of age.[1] There is a higher prevalence of CNLDO in premature infants.[3] CNLDO presents bilaterally in 14% to 34% of cases.[4] It has also been shown that anisometropic amblyopia may occur in 10% to 12% of children with CLNDO, so a proper ophthalmic eye examination and cycloplegic refraction are performed in all cases with a careful subsequent follow-up for three to four years.[5][6] Of interest is the finding of Cassidy in 1952, who noted that there was obstruction of the nasolacrimal duct in 13 of 15 stillborn infants. His postulation that patency of the nasolacrimal duct occurs within the first few days to weeks after birth is a reasonable one.[7] Children most often present within a few months of birth with epiphora and sometimes mucoid discharge from one or both sides. However, even with symptoms present since birth, patients may present when several years old. Other causes of epiphora in children like epiblepharon, congenital glaucoma, foreign body, corneal infections, and corneal dystrophies need to be excluded. Wheres the Jones 1 test where insertion of fluorescein dye into the eye is followed by the presence of dye in the nose after 5 minutes may be used, it is rarely used now since the clinical history and observation of the tearing, and mucoid discharge generally confirms the diagnosis. Similarly, the dye disappearance test over 5 minutes may also be used, but there may be significant false positive and negative results in infants.  PB - StatPearls Publishing CY - Treasure Island (FL) UR - https://www.unboundmedicine.com/medline/citation/32644693/StatPearls:_Crigler_Technique_For_Congenital_Nasolacrimal_Duct_Obstruction L2 - https://www.ncbi.nlm.nih.gov/books/NBK559267 DB - PRIME DP - Unbound Medicine ER -
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