MANAGEMENT OF PAEDIATRIC EPIPHORA AND ITS SUCCESS RATE IN A TERTIARY EYE CARE CENTRE

Abstract

Objective: To assess the children under 5years of age presenting with epiphora and to institute proper treatment with regular follow-up to get an overview of treatment success.

Materials & Methods: A prospective & non-randomized study was conducted on 518 eyes of 353patients 165(B/L) and 188 (U/L) that presented to us between April 2014- April 2015.Informed consent was taken from parents. Institutional Ethical Committee approval was taken. The patients were followed up for quarterly for 1st year to look for resolution of signs & symptoms and if required quarterly till the resolution of disease. Statistical analysis was done by using Chi-square & Fisher’s exact test to test the difference in proportions. P<0.05 was denoted as statistically significant.

Result: Congenital NLDO was the most common cause of childhood epiphora-76% (394/518) followed by trauma(iatrogenic and non-iatrogenic) seen in 18%(93/518),acquired NLDO in 4%(21/518)and punctual causes 2%(10/518). The overall treatment success rate was 82%. Individual success rate: Sac Massage: 85.9%, Probing: 73.95%, Dacryocystorhinostomy(DCR): 72%, Punctum Surgery: 100%.Though with increasing age, success rate of massage and probing reduced.

Conclusion: Sac massage is best treatment in children till 1year of age and probing is very effective till 3 years of age. Thus early treatment prevents further chances of surgical intervention.