View source for Nasolacrimal duct obstruction

==Background==
[[File:Tear system.png|thumb|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]]
*Also known as dacryostenosis
*Most common cause of tearing in children
*Occurring in up to 20% of all normal newborns and up to 6% of all children during the first year of life

==Clinical Features==
*Chronic or intermittent tearing
*Debris on the eyelashes (mattering)
*Occasionally redness of the conjunctiva

==Differential Diagnosis==
{{Neonatal eye problems DDX}}
{{Periorbital swelling DDX}}

==Evaluation==
*Clinical diagnosis
**Generally clear discharge without underlying conjunctivitis and lacrimal flow obstruction

===Dye disappearance test===
''Not always necessary, but used to test if tears are draining at proper rate (particularly for intermittent symptoms)''

#Place a drop of fluorescein-stained saline in the inferior cul-de-sac of each of eye
#Wipe away the excess tears
#Observe for five minutes (do not rub eyes or wipe tears)
#After five minutes, examine eyes
#*Normal (no obstruction): all fluorescein drained into the nose
#*Abnormal (obstructed): dye remains in eye (visible as a bright green tear meniscus) or escapes over eyelid to drain down cheek

==Management==
*Initial observation vs. duct massage

==Disposition==
*Follow up with primary care provider
**If persistent, follow up with ophthalmology

==See Also==

==External Links==

==References==
<references/>

[[Category:Pediatrics]]
[[Category:ENT]]
[[Category:Ophthalmology]]