ISSN 2398-2977      

Nasolacrimal duct: puncta - atresia

pequis
Contributor(s):

Paul E Miller


Introduction

  • The most common form of nasolacrimal duct (NLD) obstruction   Nasolacrimal duct: obstruction - acquired  (but still uncommon).
  • Incidence: presents often at 3-4 months and older.
  • Signs: uni- or bi-lateral ocular discharge and epiphora.
  • Diagnosis:
    • Nasolacrimal flush.
    • Passage of nasolacrimal catheter.
    • Passage of fluorescein dye   Cornea: fluorescein dye test  .
    • Palpation and visualization of the nasal vestibule.
  • Treatment: surgical creation of a new puncta   Nasolacrimal duct: nasal puncta opening  .
  • Prognosis: surgical treatment is highly effective.

Pathogenesis

Etiology

  • Unknown but not inherited.

Pathophysiology

  • Failure of embryologic development of nasolacrimal duct or puncta.
  • The nasolacrimal groove forms as a solid cord of ectodermal cells, from between the lateral nasal fold and maxillary process.
  • The lower end grows towards and into the rostral portion of the ventral nasal meatus.
  • Normally the entire cord canalizes to form the nasolacrimal duct.
  • Incomplete canalization, especially distally, results in an imperforate nasolacrimal system.
  • Cause is unknown.

Diagnosis

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Treatment

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Prevention

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Outcomes

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