Congenital Nasolacrimal Duct Obstruction Tears consist of three parts that are produced by glands in the eyelids. The glands of Wolfring produce the mucinous portion, the lacrimal gland and gland of Krause secrete the aqueous portion, and the meibomian glands produce the oily layer. The tears flow to the upper and lower puncta located in the upper and lower eyelid margins near the medial epicanthus. The puncta open into the upper and lower canniculi which join the common canniculus which empties into the lacrimal sac. The lacrimal sac enters the vertically placed nasolacrimal duct that enters the nasal cavity.
Most obstructions occur where the nasolacrimal duct enters the nasal cavity.
Usually there is a membrane that results from incomplete canalization. There may be epithelial debris leading to obstruction and in rare cases, the entire apparatus is not present. Presentation may be from birth to weeks and months later. Presentation Infant will have a wet eye or their parents will report crusting around the eye. There may be increased mucous in the medial corner.