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Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared with observation alone
  1. Brian G Mohney1,
  2. Saraniya Sathiamoorthi2,
  3. Ryan D Frank3
  1. 1 Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
  2. 2 Ophthalmology, Emory School of Medicine, Atlanta, Georgia, USA
  3. 3 Biostatistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Professor Brian G Mohney, Mayo Clinic, Rochester, MN 5590, USA; mohney{at}


Background/aims To determine if nasolacrimal massage or topical antibiotics are associated with higher rates of resolution compared with observation alone in a population-based cohort of infants with congenital nasolacrimal duct obstruction (CNLDO).

Methods The medical records of all children <5 years diagnosed with CNLDO while residing in Olmsted County, Minnesota from 1 January 1995 through 31 December 2004 were retrospectively reviewed for type of management and non-surgical resolution of tearing.

Results Among 1958 infants diagnosed and followed for CNLDO, 516 (26.4%) were merely observed, 506 (25.8%) were prescribed massage alone, 485 (24.8%) were prescribed at least one course of topical antibiotics, 397 (20.3%) were prescribed both topical antibiotics and massage, and 54 (2.8%) had no documented therapy. Non-surgical resolution, occurring in 1669 (85.2%) during a median follow-up of 3.1 months (range: 1 week–248 months), was 74.6% for the merely observed, 89.7% for those prescribed digital massage, 87.0% for those prescribed antibiotics and 90.7% for those treated with both. This comparison was significant in unadjusted (p<0.001) and multivariable comparisons (p<0.001).

Conclusion Prescribing topical antibiotics or digital massage for infants with CNLDO in this cohort, individually or in combination, was associated with a higher rate of spontaneous resolution than observation alone.

  • lacrimal drainage
  • treatment other

Data availability statement

Data are available upon reasonable request. All data are available in a REDCap website database from

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Data availability statement

Data are available upon reasonable request. All data are available in a REDCap website database from

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  • Presented at The study data were presented as a poster at the annual meeting of American Association of Pediatric Ophthalmology and Strabismus in Washington DC, March 2018.

  • Contributors SS contributed to the concept and design of the project, obtained data on all the subjects, interpreted the data, and reviewed and edited the manuscript. RDF contributed to the statistical design of the project, analysis of the data, and in the revision and editing of the manuscript. BGM contributed to the concept and design of the project, analysis and interpretation of data, and drafting and approving the final version for publication. Each author is agreeable to be accountable for all the work performed and the accuracy thereof.

  • Funding This publication was supported by the Rochester Epidemiology Project (grant # R01-AG034676 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases) and the Department of Ophthalmology Development Fund; Mayo Foundation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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