Study from Punctum to Valve, An Audit of Probing in Children

Published

2025-10-25

Keywords:

Congenital nasolacrimal duct obstruction, probing, lacrimal massage, membranous obstruction

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Issue

Vol. 13 No. 03 (2025): UP Journal of Ophthalmology

Section

Research Article

License

Creative Commons License

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Authors

  • Shraddha Bhardwaj Junior Resident, UpgradedDepartment of Ophthalmology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India.
  • R.C. Gupta Director Professor and Dean, UpgradedDepartment of Ophthalmology,Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
  • Lokesh Kumar Singh Associate Professor and Head, Upgraded Department of Ophthalmology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
  • Alka Gupta Professor, Upgraded Department of Ophthalmology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
  • Jaishree Dwivedi Associate Professor, Upgraded Department of Ophthalmology, Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India

Abstract

Objectives : To assess the type of obstruction, age-related outcomes, and success rates of primary and repeat probing in children with congenital nasolacrimal duct obstruction (CNLDO).

Methods : A prospective study was conducted on 426 children (625 eyes) aged 6-60 months with watering/discharge. Patients were divided into Group A (6-18 months), Group B (19-36 months), and Group C (37-60 months). Obstruction type (membranous/firm) was determined during probing. Infants <18 months initially underwent lacrimal sac massage. Probing was performed as primary or repeat. Outcomes were defined by complete symptom resolution and assessed at 1, 3, and 6 months.

Results : Membranous obstruction was observed in 91% of eyes; firm obstruction in 4%. Lacrimal massage resolved symptoms in 77.9% of Group A eyes.Out of primary probing performed probing success rates were 76.2% (Group A), 76.8% (Group B), and 50.8% (Group C).Out of Repeat probing success decreased with age: 78.5% (Group A), 56.6% (Group B), and 40.4% (Group C). Third probing had limited benefit (overall 14.2% success). Unilateral cases (53.28%) slightly outnumbered bilateral (46.71%).

Conclusion : Membranous obstruction constituted the majority of cases, while firm obstruction was infrequent. Lacrimal massage was highly effective in infants, with nearly 78% achieving symptom resolution. Primary probing demonstrated comparable success in younger age groups but declined markedly in older children. The success of repeat probings decreased progressively with age, underscoring the limited efficacy of multiple attempts. Overall, early diagnosis and timely intervention yield the most favourable outcomes.

How to Cite

1.
Bhardwaj S, Gupta R, Singh LK, Gupta A, Dwivedi J. Study from Punctum to Valve, An Audit of Probing in Children. UPJO [Internet]. 2025 Oct. 25 [cited 2026 Mar. 18];13(03):90-3. Available from: https://upjo.org/index.php/upjo/article/view/647

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