Outcome of late probing for congenital nasolacrimal duct obstruction in Singapore children

Objective: To evaluate the outcome of late probing in a mixed Asian childre n population with congenital nasolacrimal duct obstruction (CNLDO) and whet her probing was associated with an increased risk of infection. Method: A r etrospective clinical study was conducted. A clinical diagnosis of CNLDO wa s defined in an infant who presented with a history of tearing and/or eye d ischarge up to 1 year of age with no other accompanying ocular pathology. A ll patients with a presumed diagnosis of CNLDO who had probing after 12 mon ths of age were included in our study. Prior to probing, most patients had a trial of conservative treatment with massage and/or topical antibiotics. Intra-operative patency of probing was determined when metal to metal conta ct of the probe and forceps was achieved and/or when fluorescein dye was re covered from the nose after syringing. Successful probing was defined as a resolution of symptoms within 1 month after probing. Results: Seventeen pat ients involving 19 eyes fulfilled our inclusion criteria for this study. Fo urteen (82%) infants were Chinese, two Malays (12%) and the remaining one I ndian (6%). There were 10 males (59%) and 7 females (41%) and the mean age at probing was 2.2 years (range, 14 months to 5 years 6 months). The subjec ts were followed-up pest-operatively for a mean duration of 21.2 months (ra nge, 2 months to 8 years). Successful probing in our series was 89.5% (17/1 9 eyes). Of the two eyes with persistent tearing, one resolved with massage about 9 months after the unsuccessful probing; the other was referred to t he oculoplastic service for further management. Conclusion: Late probing af ter 13 months old appears to be an effective approach in the management of CNLDO in Asian infants.