Evaluation of Refractive State in Patient with Congenital Nasolacrimal Duct Obstruction

Abbas Bagheri

Purpose: To evaluate the refractive state of the patients with unilateral congenital nasolacrimal duct obstruction.

Methods: In a prospective study patients with unilateral congenital nasolacrimal duct obstruction who were referred in a two year interval and needed any type of surgery to open the lacrimal pathway entered in the study.Cycloplegic refractive state of the eyes checked, and then appropriate surgery (Probing, silicon intubation or dacrycystorhinostomy) was performed. Refractive states of two eyes were compared.

Results: 94 patients with mean age of 25.4±20.4 (range 6 month to 10 years) were entered in the study from May 2007 to January 2010.
Prevalence of anisometropia more than 0.5D was %25 and less than 0.5D was %43 and no anisometripia found in %32 of patients. When affected eyes were hyperopic the difference between affected and non affected eyes were significant from spherical (P<0.001) and spherical equivalent (P<0.001) stand points but when affected eye was myopic or emmetropic these differences were not statistically significant.
By increasing each month to the patient's age mean difference in sphere between two eyes increased 0.007D(P=0.019).

Conclusions: By increasing age at presentation of patients with lacrimal obstruction anisometropia increases. In the other hand anisometropia specially anisohyperopia in older age groups are more difficult to treat so early refraction and intervention helps to prevent amblyopia.