Dr. Devoto Martin H.
Lacrimal obstruction in the newborn is a lack of tear drainage in the lachrymal or tear duct. This is a relatively frequent condition. Up to 50% of newborns can have it. The development of the tear duct is completed after birth.
In only 5% of newborns the problem persists after 2 months of age.
During the first year of life, the chances of a spontaneous resolution are very high and depend on the child's age: at 3 months old, there are 80% chances, at 6 months, 70% chances, and 9 months, 52% chances.
The scientific publications demonstrate that, after the first year of life, the possibility of spontaneous resolution is unlikely to happen.
The most common symptoms are tearing and lid crusts.
In most cases, based on the clinical history and a thorough examination in the ophthalmologist’s office, the diagnosis can be provided. Basolacrimal duct obstruction can be resolved surgically with a canula specially designed for it. When this procedure fails, intubation is required.
The cause is congenital and is related to the lack of development of the tear duct. This condition is not hereditary.
During the first year of life there is a high index of spontaneous resolution. In the meantime, we recommend treatment with antibiotic eye drops, and massage of the lacrimal sac.
When duct obstruction persists after one year of age, surgery is indicated.
Surgery consists of introduction of a silver probe through the duct to overcome the obstruction. Permeability is the tested using a dye.
This procedure has a 90% success rate when performed in one-year-old children.
When probing fails, silastic lacrimal intubation is required. This procedure consists of the introduction of a thin, transparent filament that runs in the lachrymal duct. It remains for six months, after which it is removed and the tear duct permeability is checked.