Fawaz Hayel Alzweimel, Mohammad Eid Aleassa, Ahmed Alhusban, Mohammad Lutfi Alquran, Anas Jameel Al-rabadi.
Congenital nasolacrimal duct obstruction conservative treatment in infants using different techniques of nasolacrimal duct massage.
Rawal Med J Jan ;40(4):424-7.

Objective: To compare the effect of different techniques of nasolacrimal duct (NLD) message on symptomatic improvement of congenital nasolacrimal duct obstruction (CNLDO). Methodology: A total of 108 clinically diagnosed CNLDO in 96 infants aged less than 6 months were included in the study, which lasted for one year. Patients were prospectively randomized into two groups using two different techniques of messaging of the NLD. During the follow up period, the nasolacrimal ducts were massaged by parents. Symptomatic improvement was evaluated every month for a period of 3 months and then we continued the study using the most effective techniques of NLD message up to one year. Results: After 3 months of conversative treatment from both groups; 58 patients and 66 ducts improved, Of them; 18 patients (37.5?) and 20 ducts (38.46?) were from the first group (simple technique of NLD message) and 40 patients (83.3?) and 46 ducts (82.14?) from the second group (proper techniques of NLD message). After 6 months of conversative treatment of the total 96 patients and 108 ducts; 70 (72.9?) patients and 82 (75.9?) ducts were improved while, after one year; 88 (91.66?) patients and 94 (87.03?) ducts were improved. Conclusion: By using the proper technique of NLD message there was higher rate of spontaneous resolution of CNLD obstruction. The physician (ophthalmologist and/or pediatrician) has to spend much more time demonstrating the proper technique of NLD message to the parents.(Rawal Med J201;40:424-427).

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