Congenital nasolacrimal system obstruction.

A series of 132 children with congenital nasolacrimal system obstruction was prospectively randomized into three groups to determine the effectiveness of different modes of nonsurgical treatment. Massaging the nasolacrimal sac in a manner that increased hydrostatic pressure and ruptured the membranous obstruction was more effective (with a high degree of statistical significance) than simple massage or no massage at all. Of those children requiring nasolacrimal probing, a high success rate was found with simple obstructions in the nasolacrimal duct. Failure of probing was more common in canalicular obstructions or generally narrow nasolacrimal ducts. Silicone intubation of the nasolacrimal system is an effective way of treating cases not cured by probing.