Jahanzeb Durrani.
Non-Surgical Management of Congenital Blockade of Nasolacrimal Duct.
Ophthalmol Update Jan ;15(1):6-10.

Objective: To determine the success rate of Non-surgical Management of Congenital Nasolacrimal Duct Obstruction (CNLDO) with Crigler Massage in children below the age of one year. Study Design: Hospital based cross sectional observational study. Place and duration of study: The study was carried out in the Department of Ophthalmology at HBS General Hospital attached to Hazrat Bari Sarkar Medical & Dental College, Islamabad from 15th Nov` 2015 till 15th May 2016. Methodology: One hundred children with watering of eyes, due to congenital blockage of the distal part of the nasolacrimal duct at the Valve of Hasner, unilateral or bilateral with, no sex predisposition were included in the study. Initially, Crigler Massage was advised to all the parents for a period of 1-3 months with practical demonstration and the results were documented every fortnight. Results. There were 52 children up to the age of 6 months and 48 children between 6-12 months. 53% were male and 47% were female children. Amongst them 67% had unilateral complain and 33% were bilaterally affected. At the end of 1-3 months 90% of the children with congenital NLD blockade achieved patency, and only 10% of the cases were subjected to Bowman`s probing under short anesthesia. Conclusion: CNLDO mostly resolves spontaneously through conservative approach through Crigler Massage as an initial management, having highest success rate if done consistently. Probing and other surgical procedures should not be considered prematurely before the age of 12 months.

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