O R I G I N A L R E S E A R C H The rate of symptomatic improvement of congenital nasolacrimal duct obstruction in Japanese infants treated with conservative management during the 1st year of age Hirohiko Kakizaki1 Yasuhiro Takahashi2 Shinsuke Kinoshita1 Kunihiko Shiraki2 Masayoshi Iwaki1 1Department of Ophthalmology, Aichi Medical University, Aichi, Japan; 2Department of Ophthalmology and Visual Sciences, Osaka City University Graduate School of Medicine, Osaka, Japan Correspondence: Hirohiko Kakizaki Department of Ophthalmology,Aichi Medical University, Nagakute,Aichi, 480-1195, Japan Tel +81 561 62 3311 (ext 2181) Fax +81-561 63 7255 Email cosme@d1.dion.ne.jp Abstract: This study aimed to examine the rate of symptomatic improvement of congenital nasolacrimal duct obstruction (CNLDO) in Japanese infants treated with conservative manage- ment within the 1st year of age. Thirty-ﬁve lacrimal ducts in 27 patients diagnosed with CNLDO were included in the study. During the observational period, lacrimal ducts were massaged. As well, antibiotic eye drops, to be administered 4 times a day, were sometimes prescribed for obvious conjunctivitis. Two lacrimal ducts in 2 patients were probed before the 1st year of age because of dacryocystitis or severe blepharitis; these patients were included in the unimproved group. Twenty-nine lacrimal ducts in 21 patients resolved during the period (82.9%); with 16 lacrimal ducts resolving before six months of age. Therefore, a comparatively high percentage of resolution for CNLDO (82.9%) following conservative management was shown before the 1st year of age in Japanese infants. Keywords: congenital nasolacrimal duct obstruction, symptomatic improvement, conservative management, massage, probing Introduction Congenital nasolacrimal duct obstruction (CNLDO) is a representative entity related to epiphora of infants (Young and MacEwen 1997). Twenty percent of all neonates show epiphora during their ﬁrst month of life (Young and MacEwen 1997). However, during their ﬁrst year of life, most CNLDO patients resolve spontaneously or with just conservative management such as lacrimal massage or antibiotic eye drops (Young and MacEwen 1997; Kapadia et al 2006). This result is similar to that of early prob- ing (Katowitz and Welsh 1987; Kapadia et al 2006). However, none of the reports reporting the success rate of early probing included a spontaneous resolution control group (Young and MacEwen 1997). Furthermore, the success rate after at least two trials is much less than that of primary probing (Katowitz and Welsh 1987; Hanavar et al 2000). Therefore, conservative management is usually selected before the ﬁrst year of age (Young and MacEwen 1997; Kapadia et al 2006). However, in Japan, early probing has been recommended for CNLDO because of its high success rate (Ishikawa et al 1990; Ohki and Yamazaki 1993; Saito et al 1999). There is just one long term observation study regarding the resolution of CNLDO by conservative management in Japanese infants (Noda et al 1991). All patients in this study successfully resolved before 9 months of age. However, this outcome cannot be directly compared with other reports including some unimproved patients (Young and MacEwen 1997; Kapadia et al 2006) since these are from non-Asian countries; it being unclear whether they are applicable to Japanese infants. Clinical Ophthalmology 2008:2(2) 291–294 © 2008 Kakizaki et al, publisher and licensee Dove Medical Press Ltd.This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. 291