Pokal Upasana, Ranjan Ashish, Ali Mohammad Javed
Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, 34, India.
Am J Ophthalmol Case Rep. 2024 Jul 20;36:102117. doi: 10.1016/j.ajoc.2024.102117. eCollection 2024 Dec.
To report a rare case of a pediatric dacryolith masquerading as congenital nasolacrimal duct obstruction (CNLDO).
A two-year-old male child presented with history of intermittent epiphora and discharge since the age of six months. Clinical evaluation demonstrated raised tear meniscus height and delayed fluorescein dye disappearance test in the right eye. Lacrimal irrigation of the right eye under general anesthesia demonstrated 90 % regurgitation (subjectively) of mucoid fluid with a hard stop. Nasal endoscopy examination demonstrated a dacryolith obstructing the opening of the nasolacrimal duct (NLD) in the inferior meatus. The dacryolith was teased out of the NLD and following its removal the lacrimal irrigation was freely patent. At six-months post operative follow up, epiphora resolved and the child was asymptomatic.
While cases of canaliculitis is uncommon in pediatric age group, it is rare to find a NLD dacryolith in a toddler. To the best of the authors' knowledge, there are few prior reports on pediatric NLD dacryolith masquerading as CNLDO in a toddler (1-3 years).
报告一例罕见的小儿泪石病例，该病例伪装成先天性鼻泪管阻塞（CNLDO）。
一名两岁男童自六个月大起出现间歇性溢泪和分泌物增多的病史。临床评估显示右眼泪液弯月面高度升高，荧光素染料消失试验延迟。全身麻醉下对右眼进行泪道冲洗，主观上显示90%的黏液样液体反流且冲洗受阻。鼻内镜检查显示一枚泪石阻塞了下鼻道的鼻泪管开口。将泪石从鼻泪管中取出，取出后泪道冲洗通畅。术后六个月随访时，溢泪症状消失，患儿无症状。
虽然小儿泪小管炎病例在儿童年龄组中不常见，但在幼儿中发现鼻泪管泪石极为罕见。据作者所知，此前关于幼儿（1 - 3岁）中伪装成CNLDO的小儿鼻泪管泪石的报道很少。
