In the elderly, stenosis of the nasolacrimal duct leads to epiphora and a mucopurulent discharge. Secondary infection is common producing an acute dacryocystitis with abscess formation. The swelling is frequently painful.
Stenosis may be bypassed by dacryocystorhinostomy (DCR). Alternatives to surgical DCR include endo-nasal laser DCR and naso-lacrimal duct balloon dilation or stenting. Acute dacryocystitiis may be treated with systemic antibiotics.
In infants, the disease is due to incomplete canalisation of the lower end of the duct. This occurs in about 5-7 percent of the newborn and is a common cause of nasolacrimal obstruction. Most cases resolve spontaneously within a 10 months of birth.
Antibiotic eye ointment is indicated if there is infection. Probing of the duct or dacryocystorhinostomy may be necessary in severe cases.
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