Edit concept Question Editor Create issue ticket

Acquired Nasolacrimal Duct Stenosis

Acq Nasolacrml Stenosis


Presentation

  • Other causes of acquired specific obstructions include the following: Infection Trauma Surgical injury Neoplasm Structural Damage to the Eye If an infection is present, a palpable mass may appear at the inner canthus Palpebral conjunctiva may have papillae[decisionmakerplus.net]
  • He has to his credit 202 publications, 211 conference presentations, 20 instruction courses, 12 live surgical workshops and 26 awards.[books.google.com]
  • Symptoms/Presentation Patients with NLDO most commonly present with epiphora, mucoid or purulent discharge with a painful, swollen medical canthus. They often have features of recurrent dacryocystitis, recurrent conjunctivitis, or ocular pemphigus.[eyeplastics.com]
  • Neoplasm [ edit ] Neoplasm should be considered in any patient presenting with NLD obstruction.In patients with an atypical presentation, including younger age and male gender, further workup is appropriate.[en.wikipedia.org]
  • Presenting features are excess tearing sticky discharge and irritation. Investigations Syringing and probing to identify the site of obstruction. The Jones' fluorescein dye test. Management Treat infection if present.[patient.info]
Pain
  • […] of lacrimal system 375.56 Acq nasolacrml stenosis Code Version: 2015 ICD-9-CM References to Index of Diseases and Injuries The code 375.56 has the following ICD-9-CM references to the Index of Diseases and Injuries Cicatrix (adherent) (contracted) (painful[healthprovidersdata.com]
  • […] obstruction and determine whether it is congenital or acquired Alleviate the symptoms Determine a treatment program Patient History Patients with nasolacrimal obstruction will present with the following abnormal clinical signs and symptoms: Excessive tearing Pain[decisionmakerplus.net]
  • Moderate post-surgical pain in the socket generally occurs during the first 24 hours, but pain relievers are usually prescribed as needed to reduce this discomfort.[takleeye.com]
  • […] the "tear duct" causes a painful swelling in the inner corner of the eyelids.[eyeplasticlinic.com]
  • If dacryocystitis develops, pain is usually noted.[healio.com]
Crying
  • Tears You may only think of tears as those salty drops that fall from your eyes when you cry. Actually, your tears clean your eyes every time you blink. Tears also keep your eyes moist, which is important for your vision.[icdlist.com]
  • Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 100% You may only think of tears as those salty drops that fall from your eyes when you cry[medicbind.com]
  • Neonatal nasolacrimal duct obstruction (NLDO) presents with the parents stating that the eye is always crying. The eye remains wet leading to debris and crusting.[mhmedical.com]
  • You need tears for a lot more than crying. They flow across the surface of your eyes to clean and moisten them, then they leave your eyes through a system of tiny drainage tubes that run along your nose.[webmd.com]
Physician
  • He obtained his fellowship of Royal College of General Practitioners (FRCGP), UK in 2003 and fellowship of Royal College of Physicians and Surgeons of Glasgow (FRCS) in 2008.[books.google.com]
  • It is important to tell your physician if you have recently undergone surgery, such as sinus surgery, or have had recent trauma to your face, as these are most likely to be the causes.[care.american-rhinologic.org]
  • Physicians who manage patients with thyroid malignancy should be aware of this potential side effect of RAI therapy and understand the basics of its diagnosis and management.[omicsonline.org]
  • By using this sequence (with modifications) as a guide, the physician can frequently streamline diagnostic testing.[en.wikipedia.org]
  • The age of the infant at referral depends on the preference of the primary care physician and also on his knowledge of the surgical practice of the ophthalmologist in regard to nasolacrimal duct probing.[eyewiki.aao.org]
Falling
  • Tears You may only think of tears as those salty drops that fall from your eyes when you cry. Actually, your tears clean your eyes every time you blink. Tears also keep your eyes moist, which is important for your vision.[icdlist.com]
  • Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 100% You may only think of tears as those salty drops that fall[medicbind.com]
Lacrimation
  • H04.561 Stenosis of right lacrimal punctum H04.562 Stenosis of left lacrimal punctum H04.563 Stenosis of bilateral lacrimal punctum H04.569 Stenosis of unspecified lacrimal punctum H04.57 Stenosis of lacrimal sac H04.571 Stenosis of right lacrimal sac[icd10data.com]
  • […] punctum 375.52 Stenosis of lacrimal punctum 375.53 Stenosis of lacrimal canaliculi 375.54 Stenosis of lacrimal sac 375.55 Obstruction of nasolacrimal duct, neonatal 375.57 Dacryolith 375.61 Lacrimal fistula 375.69 Other changes of lacrimal passages 375.81[healthprovidersdata.com]
  • […] punctum or nasolacrimal duct and sac Local anesthetic is instilled, and then the lacrimal punctum is gradually dilated using probes of increasing size Dilation of the Lacrimal Punctum with Irrigation If simple dilation fails to establish patency, lacrimal[decisionmakerplus.net]
  • […] punctum 375.52 - Stenosis of lacrimal punctum 375.53 - Stenosis of lacrimal canaliculi 375.54 - Stenosis of lacrimal sac 375.55 - Obstruction of nasolacrimal duct, neonatal 375.57 - Dacryolith[emedcodes.com]
  • مقاطع مشهورة الصفحة 13 - The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. Cornea... ‏[books.google.com]
Excessive Tearing
  • A nasolacrimal duct obstruction is an acquired or congenital obstruction of the drainage system resulting in epiphora or excessive tearing. Corneal edema is a clinical sign of corneal disease.[decisionmakerplus.net]
  • Symptoms include excessive tearing. Reflux of saline or fluorescein dye when flushing the lacrimal drainage system confirms the diagnosis.[merckmanuals.com]
  • Welch, MD Introduction Epiphora, or excessive tearing, is defined as the overflow of tears from one or both eyes. Epiphora can occur continuously (be present all the time), or it can occur intermittently (be present only sometimes).[care.american-rhinologic.org]
  • Therefore, look just lateral and below the bridge of the nose for: Excess tears (epiphora) - almost invariably. Pain. Redness. Swelling.[patient.info]
  • The excessive tearing can also produce secondary skin changes on the lower eyelids. Congenital Nasolacrimal Duct Obstruction The nasolacrimal duct is a duct that connects the lacrimal glands in the eye to the nasal cavity.[eyeplastics.com]
Dry Eyes
  • Blocked tear duct Dry eye syndrome Dry eyes [ Read More ][icdlist.com]
  • مقاطع مشهورة الصفحة 13 - The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. Cornea... ‏[books.google.com]
  • eye, and blepharitis Non-invasive testing to diagnose punctal or post-punctal obstruction and to identify the site and degree of obstruction, such as by using dye disappearance testing when appropriate Initiation of appropriate treatment Dilation of[decisionmakerplus.net]
  • Values of 5-10 mm signifies moderate dry eye whereas 5 mm indicates severe dry eye Figure 4 (Click the image) 2.[eophtha.com]
Blepharitis
  • […] least the following: Consideration by history and physical examination (including slit lamp), of likely pre-punctal and/or non-obstructive causes for epiphora such as disturbances of ocular surface tear flow by eyelid malposition, allergy, dry eye, and blepharitis[decisionmakerplus.net]
  • Blepharitis can also mimic nasolacrimal duct obstruction with its associated matting and redness of the lids. Blepharitis may also be identified by the presence of flaky crusts on the lids and stye formation.[clinicaladvisor.com]
  • There are many causes of tearing, including blepharitis, trichiasis, distichiasis, eyelid malpositions, punctal stenosis, ectropion, dry eye syndrome, in addition to nasolacrimal duct stenosis and obstruction.[healio.com]
  • Ritleng tubes can be carried out with a claimed success rate of 88-95%.4,5 EPIPHORA IN ADULTS Causes of disturbed ocular surface tear flow such as lid malposition (euryblepharon, punctal ectropion, punctal phimosis) or ocular surface irritation (dry eye, blepharitis[moorfieldsresearch.org.uk]
Blurred Vision
  • The excess fluid produces a swelling of the corneal tisssue and can result in a loss of stromal transparency that produces blurred vision or visual impairment.[decisionmakerplus.net]
  • These patients often complain of epiphora and blurred vision, and sometimes they suffer from acute or chronic dacryocystitis.[unboundmedicine.com]
  • vision due to excessive tear meniscus, especially on downgaze, e.g. when reading Signs Congenital Epiphora and mucous discharge; mucopurulent if infected Pressure over lacrimal sac may cause reflux of mucous material from puncta Acquired Check puncta[college-optometrists.org]
  • This usually leads to excessive tearing and secondary blurred vision. Successful treatment is often achieved with medicated eye drops or a minor office procedure to enlarge the tear duct openings.[takleeye.com]

Workup

  • Neoplasm [ edit ] Neoplasm should be considered in any patient presenting with NLD obstruction.In patients with an atypical presentation, including younger age and male gender, further workup is appropriate.[en.wikipedia.org]
Staphylococcus Aureus
  • Staphylococcus aureus is the common bacteria causing the infection Punctal Stenosis The punctum has become blocked by some means, while the lacrimal canaliculi and nasolacrimal duct are patent Patients with epiphora of unknown etiology should undergo[decisionmakerplus.net]
  • Whilst Staphylococcus aureus is still the main cause, Gram-negative organisms are increasingly isolated). [ 6 ] The regime is guided by clinical response but, typically, a 10- to 14-day course is required.[patient.info]
  • According to them, Staphylococcus epidermidis and Staphylococcus aureus are the most frequently isolated organisms in adult lacrimal sac infections. 5-7 The treatment of LDO in adults is surgery, either external or endonasal dacryocystorhinostomy (DCR[bjo.bmj.com]

Treatment

  • By the first year of age, if the membrane has not spontaneously perforated, then the probing of the membrane is a successful treatment option.[decisionmakerplus.net]
  • Treatment of the problem depends on the cause. Blocked tear duct Dry eye syndrome Dry eyes [ Read More ][icdlist.com]
  • International experts provide a stepwise analysis and describe the clinical management of these patients with detailed medical and surgical treatment plans.[books.google.com]
  • (This prospective, nonrandomized multicenter study of 718 children with congenital nasolacrimal duct obstruction evaluated probing as a primary treatment. Treatment success was found in 78% of eyes.[clinicaladvisor.com]

Prognosis

  • Treatment and prognosis Initially, any infection should be treated with appropriate antibiotics like ciprofloxacin then probing or balloon dacryocystoplasty which usually has a successful outcome.[radiopaedia.org]
  • Prognosis : dependent upon primary cause.[vetstream.com]
  • Prognosis The prognosis for resolution of nasolacrimal duct obstruction by one or more surgical procedures is quite good. The success rate of simple probing is excellent.[eyewiki.aao.org]
  • Prognosis This is good if managed promptly and surgery is not delayed once the acute phase has resolved.[patient.info]
  • Prognosis Surgical treatment provides resolution of primary acquired nasolacrimal duct obstruction in 85%-99% of cases.[emedicine.medscape.com]

Etiology

  • Staphylococcus aureus is the common bacteria causing the infection Punctal Stenosis The punctum has become blocked by some means, while the lacrimal canaliculi and nasolacrimal duct are patent Patients with epiphora of unknown etiology should undergo[decisionmakerplus.net]
  • NLDO can be classified as either primary acquired nasolacrimal duct obstruction (PANDO) when it is idiopathic or secondary acquired lacrimal duct obstructions (SALDO) when it is secondary to various etiologies [3, 4].[link.springer.com]
  • Modifications of operative and postoperative management based on underlying etiology of NLDO may improve outcomes of endoDCR in SANDO cases.[journals.lww.com]
  • Garfin S.W. - Etiology of dacryocystitis and epiphora. Arch Ophthalmol., 1942;27(1):167-188. doi: Crossref Export Citation 8. Mauriello J.A.[degruyter.com]

Epidemiology

  • In this article, we shall briefly review the epidemiology, clinical presentation and the common causes of this condition. Epidemiology Clinical research has shown that nasolacrimal duct obstruction occurs in 2 to 4 out of 100 newborn babies.[eyeplastics.com]
  • “Two large epidemiologic studies, reported a higher risk for POAG with early menopause,” Dr. Seider wrote.[eyeworld.org]
  • EPIDEMIOLOGY OR ETIOLOGY Infectious Inflammatory Neoplastic Traumatic Mechanical SIGNS Epiphora Elevated tear meniscus height ( 2mm) Distention of the nasolacrimal sac in the inferior medial canthal region Discharge – if dacryocystitis present SYMPTOMS[webeye.ophth.uiowa.edu]
  • Epidemiology It is more common in females. It tends to occur either in infants (uncommon) or in adults (much more common) over the age of 40 years, peak age 60-70 years.[patient.info]
  • In this article, we shall briefly review the epidemiology, clinical presentation and the common causes of this condition. Clinical research has shown that nasolacrimal duct obstruction occurs in 2 to 4 out of 100 newborn babies.[eyeplasticlinic.com]
Sex distribution
Age distribution

Pathophysiology

  • Despite many studies providing useful clues, the exact pathophysiology of the obstructive process is incompletely understood.[ncbi.nlm.nih.gov]
  • Pathophysiology Stenosis and/or occlusion of the nasolacrimal duct system may occur as an acquired complication of various disease processes within the drainage system or external to it.[vetstream.com]
  • Th is protein also exists in ductal cells of the salivary glands, and may be the source of pathophysiologic salivary gland side effects [ 18 ].[omicsonline.org]
  • New insights into the pathophysiology of primary acquired dacryostenosis. Ophthalmology. 2001;108:2329–36. PubMed CrossRef Google Scholar 7. Perra MT, Serra A, Sirigu P, et al.[link.springer.com]

Prevention

  • Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 100% You may[medicbind.com]
  • As the infection develops, the nasolacrimal sac pushes on the canaliculus and prevents the sac from being reducible. As a result, the chronic stasis and build up of material leads to an infection.[decisionmakerplus.net]
  • Hospital for Sick Children Health A-Z Search a complete list of child health articles expand_more View All Drug A-Z Search a list of articles about medications expand_more View All Learning Hubs Browse a complete list of content groups Healthy Living & Prevention[aboutkidshealth.ca]
  • The lipid layer has the following functions: Decreases evaporation of the tear film It helps in maintaining the optical properties of the tear film Prevents tear overflow by maintaining a hydrophobic barrier Prevents damage to lid margin skin Aqueous[eophtha.com]
  • Sometimes these tubes can get narrowed or blocked, which prevents the tears from draining out of your eyes. This extra fluid can leave your eyes watery.[webmd.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!