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Abstract
A history of persistent excessive tearing in infants and children is a common complaint that may present a diagnostic challenge for primary care physicians. An imbalance between tear secretion and tear outflow can be created by either hypersecretion or obstruction to outflow (Epiphora).(1)
Obstruction of the nasolacrimal drainage system is common in the paediatric age group, occurring in as many as 20 - 30% of newborns. But only 1% to 6% of these children become symptomatic. Atresia of the nasolacrimal duct or dacryostenosis is the most common cause of epiphora in paediatric population. The most common site of obstruction is at the mucosal entrance into the nose (valve of Hasner) under the inferior turbinate.(2)
Congenital nasolacrimal duct obstruction can lead to various clinical manifestations including; Amniotocele, Dacryocystitis, Tearing and mattering with a mucopurulent discharge which usually manifests at 2weeks.(3)
Diagnosis includes; History of epiphora, discharge & swelling in the region of the lacrimal sac (4), and, examination of the lids, conjunctiva, cornea, tear meniscus