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ARTICLES
Year : 1976  |  Volume : 24  |  Issue : 3  |  Page : 30-32

Dacryocystography and lacrimal probing in cases of congenital obstruction of nasolacrimal duct


Department of Ophthalmology, G. R. Medical College, Gwalior (M.P.), India

Correspondence Address:
M L Agarwal
Department of Ophthalmology, G. R. Medical College, Gwalior (M.P.)
India
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Source of Support: None, Conflict of Interest: None


PMID: 1031404

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How to cite this article:
Agarwal M L, Gupta B P. Dacryocystography and lacrimal probing in cases of congenital obstruction of nasolacrimal duct. Indian J Ophthalmol 1976;24:30-2

How to cite this URL:
Agarwal M L, Gupta B P. Dacryocystography and lacrimal probing in cases of congenital obstruction of nasolacrimal duct. Indian J Ophthalmol [serial online] 1976 [cited 2019 Oct 17];24:30-2. Available from: http://www.ijo.in/text.asp?1976/24/3/30/31296

Table 1

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Table 1

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In this study, 10 cases of congenital obstru­ction of nasolacrimal duct, having chronic inflammation of lacrimal sac, have been visualised radiographically followed by lacrimal probing. The impression perceived during probing were recorded to correlate with dacryocystogram.


  Material and Method Top


Ten cases from a series of 45 patients, who at­tended Ophthalmic O. P. D. with complaint of watering or discharge from the eye since birth and did not improve by conservative line of treatment were selected for radiographical studies and lacrimal probing. Lipiodol has been used as contrast medium, following same pro­cedure in injection and radiographic technique as des­cribed previously by Agarwal.[1] Lacrimal probing was done following same procedure as described previously by Agarwal.[2] In all the cases Ketamine anaesthesia was used for radiography and probing.


  Observation Top


Radiographic observation with comments on impression perceived during probing and patency are dicussed below:

Case No. 1. (lateral view)

Sac was dilated with regular outline and showed a block at the sac duct junction.

Probe passed with resistance at sac duct junction, indicating fibrosis. Passage became patent after probing. [Figure - 1]

Case No. 2-(lateral view)

Sac was small and irregular. Dye in naso­lacrimal duct showed block at the lower end of nasolacrimal duct.

Probe passed without any resistance indicat­ing a thin membrane at the lower end. [Figure - 2]

Case No. 7-(P. A. View)

Case no. 7

A small and stenosed sac was visualized. The case had a fistula. Docryocysto graph showed a block at sac duct junction.

Probe could be passed with resistance at the sac duct junction indicating fibrosis. Passage did not get patent even after probing twice. Patient had a fistula and was advised pro­bing again [Figure - 3]. Patient did not come for follow up.

Dilated and elongated sac with pouch (filling defect) was seen and the block was at the sac duct junction.

Probe passed with resistance at sac duct junction indicating fibrosis. Passage was patent. after probing [Figure - 4].

Case No. 14-(P.A. View)

Sac was dilated, elongated and had a pouch (filling defect). Block was at the sac duct junc­tion.

Probe could be passed without any resistance indicating presence of debris or mucous in the duct. [Figure - 5]

Sac was oval, dilated and elongated and the block was at the sac duct junction.

Probe passed with resistance at sac duct junction, indicating fibrosis.


  Comments Top


According to developmental anatomy the last point to become patent, during process of canalisation, is the lower end of the duct. Patency at this point may often not be comple­ted at birth. Dacryocystogram in such cases, should show block at the lower end of the duct. Guerry[3] and Weldeptel[4] reported block at the upper end of the duct, as shown by roentogeno­logical study of their cases and explained this on the presumption that debris filling the duct did not allow the dye to enter the canal. In the present study eight cases showed block at the upper end of the duct (sac duct junction) and two cases showed block at the lower end. During probing in these cases, resistance was felt at the sac duct junction in five cases, while in three cases, no resistance was felt. In 3 cases where no resistance was felt, the duct was full of debris and mucous, which was pushed out while probing resulting in patency. Five cases who offered resistance seem to have deve­loped a thin fibrous membrane over debris­mucous filled duct at sac duct junction. This membrane once ruptured by a probe, pushing out debris mucous also resulted in patency on syringing.

Two cases who had block at the lower end of the duct did not offer resistance to probing showing that thin membrane at the lower end remained imperforated, which gave way to probing resulting in patency.

The dacryocystography has shown, lacrimal sac in varying size and shape with regular outline and pouches (filling defect).


  Summary and Conclusion Top


Ten cases of congenital obstruction of naso­lacrimal duct have been visualised radiographi­cally followed by probing, The impression perceived during probing were recorded to correlate with dacryocystograms.

 
  References Top

1.
Agarwal, M.L., 1961, Amer. J. Ophthal., 52, 245.   Back to cited text no. 1
    
2.
Agarwal, M.L., 1968, Antiseptic, 64, 271.   Back to cited text no. 2
    
3.
Guerry et al, 1948, Jour. Paediat , 36, 212.  Back to cited text no. 3
    
4.
Waldaptel, R., 1954, Amer. J. Ophthal., 37, 768.  Back to cited text no. 4
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6]
 
 
    Tables

  [Table - 1]



 

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