Nasolacrimal Duct Obstruction Flashcards
What is the typical history associated with nasolacrimal duct obstruction?
Chronic tearing or discharge from one or both eyes. Recurrent eye infections or inflammation. History of congenital or acquired duct obstruction.
What are the key physical examination findings in nasolacrimal duct obstruction?
Epiphora (overflow of tears onto the face). Mucopurulent discharge with pressure over the lacrimal sac. Absence of conjunctival redness or corneal involvement.
What investigations are necessary for diagnosing nasolacrimal duct obstruction?
Clinical diagnosis based on history and physical exam. Fluorescein dye disappearance test to assess tear drainage. Imaging (e.g., dacryocystography) in complex cases.
What are the non-pharmacological management strategies for nasolacrimal duct obstruction?
Lid hygiene and massage of the lacrimal sac. Warm compresses to alleviate discomfort. Educate parents on gentle massage techniques in infants.
What are the pharmacological management options for nasolacrimal duct obstruction?
Topical antibiotics if secondary infection is present. Consider probing of the nasolacrimal duct in persistent cases. Surgical options for refractory cases.
What are the red flags to look for in nasolacrimal duct obstruction patients?
Severe pain or swelling over the lacrimal sac. Fever or signs of systemic infection. Persistent symptoms despite conservative management.
When should a patient with nasolacrimal duct obstruction be referred to a specialist?
Persistent obstruction not responding to initial treatment. Recurrent dacryocystitis or complications. Need for surgical intervention or further evaluation.
What is one key piece of pathophysiology related to nasolacrimal duct obstruction?
Blockage of the nasolacrimal duct leading to tear stasis. Can be congenital or acquired. Results in chronic tearing and risk of infection.
