Outcome of Nasolacrimal Probing Without Syringing in Congenital Nasolacrimal Duct Obstruction Under Inhalational Anaesthesia in Infants of 6-12 Months of age

Aim: To evaluate the results of early probing in congenital nasolacrimal duct obstruction without syringing from lower punctum under inhalational anaesthesia in 6-12 months old infants. Study design: A descriptive case series. Methods: 44 eyes of 36 infants between 6 to 12 months of age with complaints of constant epiphora with or without discharge and regurgitation on pressure over the lacrimal sac were included in the study. Patients with history of previous probing, declared unsuitable by the ENT specialist or the anaesthetist were not included in the study. After the written consent of the parents, all underwent probing of the nasolacrimal passage from the lower punctum under inhalational anaesthesia. Patients were sent home after a few hours with conservative treatment and were followed up for 1 month postoperatively and the procedure was repeated after 2 months in unsuccessful cases. Results: Success of probing was defined as complete remission of the symptoms and a negative regurgitation test throughout the period of follow up. 20 (55%) infants were male and 16 (45%) females. The incidence was more(72%) in 6-9 months age group and more unilateral (77.7%) than bilateral (22.3%). 37 (84.09%) infants presented with epiphora with mucoid or mucopurulent discharge and 7 (15.90%) presented without discharge. Fluorescein dye disappearance test (FDDT) was absent in all the patients and regurgitation test was positive in 39 (88.63%) eyes. 34 out of 44(77%) eyes were cured after the 1st, 7 out of remaining 10(70%) after the 2nd and 0 (0%) out of 3 eyes after the 3rd probing. The overall success rate was 93% and the procedure failed in 7%. Conclusion: Early probing between the age of 6-12 months is advantageous because it is cost effective, less apprehensive to the parents, provides instant relief, decreases the incidence of complications and thus avoids months of morbidity.