The nasolacrimal duct is a duct that connects the lacrimal glands in the eye to the nasal cavity. In this article, we shall briefly review the epidemiology, clinical presentation and the common causes of this condition.
|congenital fistula (as seen to the left)|
|congenital dacryocele or mucocele|
Nasolacrimal duct obstruction is not very common but does have some recognised causes. The top three causes include –
It is commonly accompanied by other eye abnormalities.
Acquired (ADULT-ONSET) Nasolacrimal Duct Obstruction
Epiphora is the overflow of tears which is caused by an imbalance in tear production and tear drainage. Other than conditions that cause an abnormal increase in tear production, an abnormality in tear drainage is the most likely cause of epiphora. It might possibly be either functional due to a displaced punctum, eyelid laxity, weak orbicularis, or facial nerve palsy or an anatomical obstruction might possibly block the drainage of tears. Anatomical obstruction of the nasolacrimal duct might possibly be congenital which occurs during the neonatal period or acquired which manifests during adulthood.
Classification of Acquired Nasolacrimal Drainage Obstruction (NLDO)
Acquired nasolacrimal drainage obstruction might possibly be primary or secondary.
Inflammatory lacrimal drainage obstruction: May be endogenous or exogenous in origin.
Neoplastic lacrimal drainage obstruction: Neoplasms cause obstruction by primary growth, secondary spread, or metastatic spread.
Traumatic lacrimal drainage obstruction: May be iatrogenic or non-iatrogenic.
Mechanical lacrimal drainage obstruction
On examination, the following findings might possibly be present.
|The photo and CT on the left represents a nasolacrimal duct tumor which can lead to in a nasolacrimal duct obstruction.
Once the tumor was removed, silicone intubation performed, the patient's symptoms of tearing resolved
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