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Letters to the Editor

Probing in Children Older than 13 Months

Bajaj, Mandeep S. MD; Pushker, Neelam MD; Chaturvedi, Amrita MD; Chandra, Mahesh MD; Mehta, Mridula MD

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Indian Journal of Ophthalmology: Apr–Jun 2005 - Volume 53 - Issue 2 - p 144
doi: 10.4103/0301-4738.16185
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Dear Editor,

We read with keen interest the recent article on the outcome of probing in children older than 13 months of age.1 We fully agree with the contention that probing should be the initial intervention in such cases. Even if the child has had multiple failed probings done elsewhere, it is always worthwhile to give the benefit of at least one probing as it may obviate the need for a relatively major lacrimal drainage procedure. We would like to raise a few pertinent issues which might help in a better understanding of this important clinical entity.

In this series, the oldest child reported is 7 years of age. So in Group 2, the age ranges from 24 months to 7 years. There may have been subtle differences in the results within this rather large class interval. It would have been much more beneficial if the authors would have subdivided this group into smaller subgroups, so as to assess the gradation of the success rate in various age categories of older children.

We would also like to know if any form of rhinological evaluation, such as an endoscopic nasal examination was performed in any of the patients. Data on the anatomical variations at the lower end of the nasolacrimal duct, as well as significant nasal pathologies would be useful in all cases. However, it would assume special significance in patients where probing was not successful, as one could then decide on the further course of management i.e. whether to use an adjunctive procedure with another probing or to go ahead with a dacryocystorhinostomy at the appropriate age.

Reference

1. Maheshwari R. Results of probing for congenital nasolacrimal duct obstruction in children older than 13 months of age Indian J Ophthalmol. 2005;53(1):49–51
© 2005 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow