Search Our Scientific Publications & Authors

Middle East Afr J Ophthalmol 2018 Jul-Dec;25(3-4):156-160

Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Background/aims: To evaluate the refractive status, axial length, and prevalence of amblyopia among Saudi children with unilateral congenital nasolacrimal duct obstruction (UCNLDO) compared to the unaffected fellow eye.

Methods: A retrospective chart review was performed for children with UCNLDO at two eye institutes in Eastern Saudi Arabia from 2009 to 2015. The outcomes of syringing determined UNCLDO. Read More

Clin Perinatol 2018 12 18;45(4):751-767. Epub 2018 Sep 18.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, 601 North Caroline Street, Room 6161B, Baltimore, MD 21287, USA.

Congenital nasal deformities can cause nasal obstruction with early respiratory distress. Choanal atresia is characterized by no communication between the nasal cavity and nasopharynx. Pyriform aperture stenosis involves more anterior nasal obstruction with limited intranasal space. Read More

BMC Ophthalmol 2018 Oct 30;18(1):283. Epub 2018 Oct 30.

Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, 1 Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.

Background: Universal ocular screening of infants is not a standard procedure in children's health care system in China. This pilot study investigated prevalence of ocular abnormalities of 6 weeks-age infants using wide-field digital imaging system.

Methods: Infants aged 6 weeks around were consecutively enrolled in a public hospital between April 2015 and August 2016. Read More

Orbit 2018 Sep 5:1-3. Epub 2018 Sep 5.

b Govindram Seksaria Institute of Dacryology , L.V. Prasad Eye Institute , Hyderabad , India.

Rubinstein-Taybi syndrome is a rare multisystem disorder characterized by broad thumbs and first toes, short stature, microcephaly, delayed milestones, beak nose, and hypertelorism. Lacrimal drainage anomalies are not uncommon in this syndrome. We present a patient with Rubinstein-Taybi syndrome with bilateral congenital nasolacrimal duct obstruction and left-sided grossly dilated nasolacrimal duct. Read More

Orbit 2018 May 24:1-4. Epub 2018 May 24.

a Govindram Seksaria Institute of Dacryology , L.V. Prasad Eye Institute , Hyderabad , India.

Purpose: To report the outcomes of external dacryocystorhinostomy (Ext DCR) in paediatric patients.

Methods: A single-centre, retrospective, interventional, non-comparative case series was performed on all paediatric patients who underwent Ext DCR between July 2010 and July 2014. Surgery was performed as per standard Ext DCR protocols with only anterior flap suturing. Read More

Orbit 2018 May 22:1-5. Epub 2018 May 22.

a Govindram Seksaria Institute of Dacryology , L.V. Prasad Eye Institute , Hyderabad , India.

Purpose: The purpose of the article is to report the outcomes of powered endoscopic dacryocystorhinostomy (PEnDCR) in pediatric patients.

Methods: A single-center, single surgeon, retrospective, interventional, non-comparative case series was performed on all pediatric patients who underwent PEnDCR between July 2014 and July 2017. Patients with associated congenital anomalies like single punctum agenesis or lacrimal fistula were excluded. Read More

J Pediatr Ophthalmol Strabismus 2018 Jul 1;55(4):266-268. Epub 2018 May 1.

Purpose: To assess the association of congenital nasolacrimal duct obstruction (CNLDO) with mode of birth (vaginal or cesarean).

Methods: This study was a prospective interventional case series of 200 consecutive cases of CNLDO presenting at a tertiary care center. Data collected include demographics, mode of delivery, elective or emergency cesarean section, primary or secondary cesarean sections, type of CNLDO (simple or complex), management, and outcomes. Read More

Eur Arch Otorhinolaryngol 2018 Jun 16;275(6):1469-1475. Epub 2018 Apr 16.

Department of Otolaryngology, Alexandria Faculty of Medicine, 4 Kafr Abdou street # 605, Alexandria, 21529, Egypt.

Purpose: The current management options of congenital pyriform aperture stenosis (CNPAS) are either conservative measures awaiting further growth of the bony nasal framework or surgical intervention that focuses on bone removal from the margin of the pyriform aperture (PA) without exposure of the nasolacrimal duct (NLD) followed by stenting. Recently, CT measurements of the nasal cavity in CNPAS have shed light that the site of maximal bony obstruction corresponds to the bony buttress encasing the NLD rather than the margin of the PA as initially thought. Herein, we present an extramucosal pyriplasty technique that can be used without stenting to enlarge the PA and achieve immediate and sustained relief of nasal obstruction. Read More

Ophthalmic Plast Reconstr Surg 2018 Jul/Aug;34(4):e110-e113

Department of Ophthalmology, Lady Hardinge Medical College, University of Delhi.

Amniotic band syndrome is a rare congenital disorder caused by entrapment of fetal parts (usually a limb or digits) in fibrous amniotic bands while in utero that presents with complex multisystem anomalies. The authors report 2 children with amniotic band syndrome who presented to the ophthalmic unit of the authors' pediatric hospital. One of them presented with telecanthus, syndactyly, amputated toes, and unilateral epiphora diagnosed as congenital nasolacrimal duct obstruction. Read More

J Fr Ophtalmol 2018 Mar 23;41(3):206-211. Epub 2018 Mar 23.

Ophthalmology Department, University Hospital Necker-Enfants malades, AP-HP, Paris V René Descartes University, 149, rue de Sèvres, 75015 Paris, France; CNRS Research Unit FR3636, Paris V University, 75005 Paris, France.

Background: Tearing and conjunctivitis in children are commonly due to lacrimal drainage system obstruction. Congenital nasolacrimal obstruction is a common pathology treated by probing with or without silicone stent insertion, depending upon the age of the child. The silicone stent is self-retaining and placed for at least one month. Read More

J Coll Physicians Surg Pak 2018 03;28(3):210-213

Department of Pediatric Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi.

Objective: To evaluate the state of refraction in children with bilateral congenital nasolacrimal duct obstruction (CNLDO).

Study Design: Descriptive study.

Place And Duration Of Study: Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from April 2014 to April 2016. Read More

Clin Ophthalmol 2017 9;11:1975-1977. Epub 2017 Nov 9.

Govindram Seksaria Institute of Dacryology, L. V. Prasad Eye Institute, Hyderabad, India.

Purpose: The objective of this study was to ascertain the lacrimal drainage anomalies in a cohort of patients suffering from congenital rubella syndrome (CRS).

Methods: This was a retrospective case series performed in patients with CRS presenting with associated lacrimal drainage anomalies (LDA) over 6 years from 2011 to 2016. All the patients were confirmed as having CRS after clinical and laboratory testing. Read More

Orbit 2018 Aug 17;37(4):257-261. Epub 2017 Oct 17.

b Department of Oculoplasty , Dr Shroff's Charity Eye Hospital , New Delhi , India.

Congenital nasolacrimal duct obstruction (CNLDO) remains the most common cause of epiphora in infants. This retrospective study compares the success rate of nasal endoscopic-assisted probing between younger (3 years and below) and older (above 3 years) children with membranous CNLDO and its correlation with the thickness of the membrane at the valve of Hasner. Case records of a total of 38 eyes in 34 children with membranous CNLDO who underwent endoscopic nasolacrimal duct probing and irrigation under general anesthesia were analyzed. Read More

J Pediatr Ophthalmol Strabismus 2018 Jan 9;55(1):65-67. Epub 2017 Oct 9.

Purpose: To compare success and extrusion rates of the monocanalicular and bicanalicular Crawford intubation systems (JEDMED Instrument Company, St. Louis, MO).

Methods: A retrospective review of all children who were diagnosed as having congenital nasolacrimal duct obstruction and treated with lacrimal intubation from 2005 to 2014 was performed. Read More

J Craniofac Surg 2017 Nov;28(8):e725-e728

*Department of Oral and Maxillofacial Radiology †Department of Orthodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey.

Objective: The cleft lip/palate (CLP) deformity negatively affects the anatomy of the nasal cavity and maxilla. The effects of this deformity on the lacrimal system have been unidentified yet. This study aimed to evaluate the morphometric changes in the nasolacrimal duct using cone-beam computed tomography (CBCT) in patients with unilateral CLP. Read More

Orbit 2017 Oct 16;36(5):298-300. Epub 2017 Aug 16.

a Department of Ophthalmology , Sussex Eye Hospital , Eastern Road, Brighton , United Kingdom.

The treatment of midfacial tumours with radiotherapy, chemotherapy and radio-iodine can cause nasolacrimal duct fibrosis resulting in epiphora. Nasolacrimal patency can be maintained by stenting. We report our experience of prophylatic Nunchaku stent insertion in 5 patients prior to midfacial radiotherapy. Read More

J Pediatr Ophthalmol Strabismus 2017 Jul 17;54(4):238-243. Epub 2017 May 17.

Purpose: To characterize anatomical variations of the nasolacrimal canal in patients with complex congenital nasolacrimal duct obstruction.

Methods: Retrospective case series of 25 children with congenital nasolacrimal duct obstruction. All children had failed probings and were examined by computed tomography. Read More

J Coll Physicians Surg Pak 2017 Mar;27(3):145-148

Ophthalmology, Hazrat Bari Sarkar Medical and Dental College Hospital, Islamabad.

Objective: To determine the success rate of non-surgical management of congenital nasolacrimal duct obstruction (CNLDO) with Crigler massage in infants below the age of one year.

Study Design: A cross-sectional observational study.

Place And Duration Of Study: Department of Ophthalmology at HBS General Hospital, Hazrat Bari Sarkar Medical and Dental College, Islamabad from November 2015 to May 2016. Read More

Indian J Dent Res 2017 Jan-Feb;28(1):105-108

Director and Consultant, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India.

Tessier facial clefts are among the rarest facial clefts reported in literature and many contradicting issues have always been rising over the management and surgical approaches involved during the craniofacial cleft repair. Among the craniofacial clefts Tessier no. 4 is an extremely rare facial anomaly, and there are very few evidence which clearly describe the surgical approaches and techniques. Read More

Orbit 2017 Jun 8;36(3):137-143. Epub 2017 Mar 8.

a Govindram Seksaria of Dacryology , L. V. Prasad Eye Institute , Hyderabad , India.

The aim of this study was to illustrate the surgical techniques and utility of stereotactic or image-guided navigation in the management of lacrimal drainage obstruction in congenital arhinia-microphtalmia syndrome and review the relevant literature. Image-guided combined external and endoscopic dacryocystorhinostomy was performed in a female, aged 16 years with congenital partial arhinia and ipsilateral microphthalmus. The lacrimal sac was bypassed to the contra lateral nasal cavity through a septal window. Read More

Cesk Slov Oftalmol Fall 2016;72(5):178-181

Purpose: To compare the success rate of monocanalicular (MI) and bicanalicular intubation (BI) in congenital nasolacrimal duct obstruction (CNLDO).

Methods: MI through the inferior canaliculus and BI were performed under general anaesthesia in children from 7 to 24 months old with CNLDO. Only children after unsuccessful conservative therapy and two and more probings were included in the study. Read More

J Pediatr Ophthalmol Strabismus 2017 Jan;54(1):6-9

Eur J Ophthalmol 2017 Jun 20;27(4):502-505. Epub 2016 Dec 20.

Department of Ophthalmology, Faculdade de Medicina de Botucatu-UNESP, São Paulo - Brazil.

Purpose: To survey the management of congenital nasolacrimal duct obstruction (CNLDO) by pediatric primary health care providers in Spain.

Methods: This was a descriptive study using a web-based questionnaire to evaluate the perceptions of the members of the Pediatric Primary Care Society in Castilla-León, Spain (APAPCYL), regarding management of CNLDO. The questionnaire contained 14 direct questions and was sent by e-mail to all the pediatricians. Read More

J Pediatr Ophthalmol Strabismus 2017 Mar 16;54(2):123-127. Epub 2016 Dec 16.

Purpose: To report the success rate of children undergoing probing for congenital nasolacrimal duct obstruction (CNLDO) and the factors relating to the failure of the procedure.

Methods: This retrospective case series included 88 eyes of 62 patients, aged 1 to 138 months, who underwent probing between January 2008 and December 2014 in the Pediatric Ophthalmology Unit of Centro Hospitalar São João. The procedure was performed in the operating room under general anesthesia. Read More

BMJ Case Rep 2016 Dec 9;2016. Epub 2016 Dec 9.

All India Institute of Medical Sciences, Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India.

J Pediatr Ophthalmol Strabismus 2016 Sep;53(5):270

Indian J Ophthalmol 2016 Jul;64(7):496-9

Department of Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.

Purpose: To report the prevalence of amblyopia risk factors in children with congenital nasolacrimal duct obstruction.

Methods: A retrospective review of records of children with the diagnosis of congenital nasolacrimal duct obstruction (NLDO), who underwent probing from January 2009 to October 2011, was done. All of them underwent a complete ophthalmic evaluation including cycloplegic refraction and strabismus evaluation before probing. Read More

Ophthalmic Plast Reconstr Surg 2017 May/Jun;33(3):e66-e69

The Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad-34, India.

Incomplete punctal canalization is a form of punctal dysgenesis with membranous noncanalization and can be confused with punctal agenesis. The clinical and diagnostic features are known; however, familial incomplete punctal canalization has not been reported earlier. A family with 3 affected members is presented in this series with similar incomplete punctal canalization and nasolacrimal duct obstructions. Read More

J Pediatr Ophthalmol Strabismus 2016 Jul 5;53 Online:e29-31. Epub 2016 Jul 5.

Methicillin-resistant Staphylococcus aureus is one of the toughest organisms to treat, especially in cases where intraocular surgery is contemplated, because the risks are aggravated. Conjunctival swab culture and sensitivity tests are significant when there is history of recent hospitalization. In this report, an infant with successful cataract surgery after elimination of the organism is presented. Read More

J Anat 2016 11 27;229(5):657-672. Epub 2016 Jun 27.

School of Biology and Environmental Science, University College Dublin, Dublin, Ireland.

A normal feature of the facial anatomy of many species of bat is the presence of bony discontinuities or clefts, which bear a remarkable similarity to orofacial clefts that occur in humans as a congenital pathology. These clefts occur in two forms: a midline cleft between the two premaxillae (analogous to the rare midline craniofacial clefts in humans) and bilateral paramedian clefts between the premaxilla and the maxillae (analogous to the typical cleft lip and palate in humans). Here, we describe the distribution of orofacial clefting across major bat clades, exploring the relationship of the different patterns of clefting to feeding mode, development of the vomeronasal organ, development of the nasolacrimal duct and mode of emission of the echolocation call in different bat groups. Read More

Jpn J Ophthalmol 2016 Jul 27;60(4):274-9. Epub 2016 Apr 27.

Department of Ophthalmology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.

Purpose: Our aim was to review the success rates of dacryoendoscopy-guided probing for recalcitrant congenital nasolacrimal duct obstruction (CNLDO).

Methods: We reviewed the medical records of 498 patients (521 eyes) diagnosed with CNLDO between January 2011 and November 2013. Of these, 54 eyes met the eligibility criteria and underwent probing with a dacryoendoscope. Read More

Pediatr Rep 2016 Mar 31;8(1):6456. Epub 2016 Mar 31.

Departments of Ear, Nose, Throat-Head and Neck Surgery, Faculty of Medicine, Adnan Menderes University , Aydın, Turkey.

Since newborns are obligatory nasal breathers, upper respiratory tract problems may sometimes be life threatening. The most common pathology causing dyspnea and stridor in newborns is laryngomalacia. Nasal cavity pathologies that risk the neonatal airway are more rarely met. Read More

Indian J Ophthalmol 2015 Oct;63(10):800-3

Department of ENT, R. G. Kar Medical College, Kolkata, West Bengal, India.

Ectrodactyly-ectodermal dysplasia and clefting syndrome or "Lobster claw" deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD) obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mild mental retardation, otitis media, and sinusitis. Read More

Indian J Dermatol Venereol Leprol 2015 Nov-Dec;81(6):646-8

Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Pediatr Int 2015 Jun 27;57(3):475-7. Epub 2015 May 27.

Department of Otolaryngology, University of Tokushima School of Medicine, Tokushima, Japan.

Congenital dacryocystocele is a relatively rare type of nasolacrimal duct obstruction that may induce respiratory distress during the early neonatal period. We encountered a case of bilateral congenital dacryocystoceles with intranasal cysts in a premature infant delivered at 34 weeks of gestation. The patient developed symptoms of respiratory failure immediately after birth, but no ophthalmologic symptoms. Read More

Klin Monbl Augenheilkd 2015 Jul 7;232(7):881-5. Epub 2015 Apr 7.

Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale.

Background: Pathologies of the lacrimal duct system show a frequent occurrence in paediatric ophthalmology. Mostly, the connection between the nasolacrimal duct and the nose fails to open but also combined diseases or congenital anomalies may be the reason. Because of complications, the chance for healing after a conservative therapeutic approach decreases and surgical intervention is necessary. Read More

Ultraschall Med 2015 Oct 5;36(5):517-9. Epub 2015 Mar 5.

Int Ophthalmol 2015 Dec 14;35(6):807-10. Epub 2015 Feb 14.

Dacryology Service, L.V. Prasad Eye Institute, Road No 2, Banjara Hills, P.O. Box 34, Hyderabad, India.

The purpose of this study was to report various conditions masquerading as congenital nasolacrimal duct obstruction (CNLDO). Retrospective review was designed in a tertiary hospital setting. 92 eyes of 65 consecutive patients were included in this study. Read More

Can J Ophthalmol 2015 Feb;50(1):e7-8

The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.

J Pediatr Ophthalmol Strabismus 2015 Jan-Feb;52(1):12

Zhonghua Yan Ke Za Zhi 2014 Dec;50(12):911-4

National Key Discipline of Pediatrics, Ministry of Education, Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.

Objective: To explore the radiographic characteristics of nasolacrimal canals in congenital nasolacrimal canal agenesis.

Methods: Retrospective case series study. The images of Computed Tomography of 18 children with unilateral congenital nasolacrimal canal agenesis who were treated in Beijing Children's Hospital from January 2009 to June 2013 were studied. Read More

Ophthalmologe 2015 May;112(5):455-8

Zentrum für Augenheilkunde, Universität zu Köln, Universitätsklinikum Köln, Kerpener Str. 62, 50924, Köln, Deutschland,

A 2-year-old boy suffering from Cornelia de Lange syndrome, presented with mucopurulent ocular discharge and epiphora since birth. Irrigation and probing of the nasolacrimal system revealed and successfully treated bilateral nasolacrimal duct obstructions. Cornelia de Lange syndrome is characterized not only by typical facial features, visceral and urogenital anomalies but also by ophthalmological manifestations in 99% of cases. Read More

Ophthalmic Plast Reconstr Surg 2015 Jul-Aug;31(4):318-20

Dacryology Service, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.

Purpose: To report the clinical profiles and outcomes of buried probe variant of complex congenital nasolacrimal duct obstruction (CNLDO).

Methods: Retrospective chart review of all patients endoscopically diagnosed as a buried probe variant of complex CNLDO, over a 3.5 year period from a single surgeon's (MJA) database were included in the study. Read More

Arq Bras Oftalmol 2014 Aug;77(4):261-3

Departamento de Oftalmologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Congenital dacryocystocele is an unusual type of nasolacrimal obstruction. Treatment with antibiotics or surgical removal is practiced to reduce the risks of infection (acute dacryocystitis) and potentially lethal septicemia. Here, we report a case of congenital dacryocystocele, antenatal ultrasonographic diagnosis (intrauterine), and postnatal reassessment. Read More

Semin Ophthalmol 2016 6;31(3):275-9. Epub 2014 Nov 6.

a Department of Ophthalmology , Meir Medical Center , Kfar Sava , Israel.

Objectives: Epiphora (excess tearing) is a common complaint among patients visiting ophthalmology clinics. The etiology of epiphora in patients presenting to a primary ophthalmologist might be very different compared to those referred to an oculoplastic unit.

Purpose: To describe the etiology of epiphora in patients referred to an oculoplastics clinic. Read More

Int Forum Allergy Rhinol 2015 Feb 3;5(2):174-7. Epub 2014 Nov 3.

Dacryology Service, L.V. Prasad Eye Institute, Hyderabad, India.

Background: The aim of this study was to report the comparative clinical profiles and outcomes of simple and complex congenital nasolacrimal duct obstruction (CNLDO).

Methods: The study was a retrospective chart review of all patients presenting with CNLDO from a single surgeon's (M.J. Read More

J Pediatr Ophthalmol Strabismus 2015 Jan-Feb;52(1):14-9. Epub 2014 Nov 4.

Purpose: To study common management policies of congenital nasolacrimal duct obstruction (CNDLO) among pediatric ophthalmologists.

Methods: A 21-question survey was sent to members of the American Association for Pediatric Ophthalmology and Strabismus in April 2014. The questions focused on treatment of CNLDO during the first year of life, primary and secondary surgical interventions, surgical techniques, and amblyopia assessment. Read More

Ophthalmic Plast Reconstr Surg 2014 Nov-Dec;30(6):e167

Dacryology Service, L.V. Prasad Eye Institute, Hyderabad, India (E-mail:

Br J Ophthalmol 2014 Nov 11;98(11):1583-7. Epub 2014 Jun 11.

Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu, Sichuan, China.

Aims: To prospectively evaluate the reliability and efficacy of a new treatment for the reconstruction of the lacrimal duct using a new histo-engineered material, xenogeneic (bovine) acellular dermal matrix.

Method: Five patients (five eyes) with partial or total absence of the lacrimal duct were included in the study. Four patients (four eyes) suffered from traumatic injuries to the lacrimal duct and one patient (one eye) had congenital absence of the lacrimal drainage system. Read More

Br J Ophthalmol 2015 Feb 2;99(2):246-50. Epub 2014 Sep 2.

Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Purpose: To compare the success rates of probing versus bicanalicular silastic intubation as the primary treatment for congenital nasolacrimal duct obstruction (CNLDO) in children ≥1 year old.

Study Design: Prospective, randomised, comparison.

Methods: Participants were randomised to undergo probing or bicanalicular silastic intubation. Read More