THE NATURAL-HISTORY OF EPIPHORA IN CHILDHOOD

Purpose To investigate the incidence and aetiology of epiphora in a po pulation of 7-year-old children and determine whether a conservative m anagement policy for congenital nasolacrimal duct obstruction (CNLDO) results in excess lacrimal dysfunction in later childhood. Methods A p ostal questionnaire was sent to the parents of a large cohort of 7-yea r-old children previously investigated to determine the incidence and natural progression of CNLDO. They were asked about the presence of ep iphora, and its relationship to atopic disease and the presence of upp er respiratory tract infections (URTI). Information on epiphora had al so been gathered from the same cohort at age 3 1/2 years at a routine examination. Data were compared with those for epiphora in infancy in the same cohort. Results The incidence of epiphora at 3 1/2 years was 5.5%, and 7 years 7.7%. At age 7 years 70% of cases were related to at opic disease or URTI. CNLDO was not significantly related to epiphora in later childhood (p = 0.000032). Conclusions A policy of delaying na solacrimal probing in CNLDO until after the age of 1 year does not res ult in a detectable excess of lacrimal dysfunction in later childhood, when epiphora is more likely to be related to atopic disease or upper respiratory tract infection.