Pediatric nasolacrimal duct obstruction

PURPOSE OF REVIEW: Review the current management for pediatric nasolacrimal duct obstruction and congenital dacryocele. RECENT FINDINGS: Early probing in the office, and probing beyond 1 year of age in a facility with general anesthesia are equally effective. Congenital nasolacrimal duct obstruction is associated with anisometropic amblyopia. Infants with unilateral dacryocele are at risk for developing a dacryocele on the unaffected side. SUMMARY: The decision to probe early in the office or continue medical management and probe beyond a year of age in a facility with a general anesthetic is at the discretion of the ophthalmologist. Failed probings should be treated in a facility under general anesthesia with a balloon catheter or intubation. Children with congenital nasolacrimal duct obstruction need to be followed to make certain they do not develop anisometropic amblyopia.