What is Nasolacrimal Duct Probing

Nasolacrimal duct probing is a surgical procedure to open up an underdeveloped nasolacrimal duct. A nasolacrimal duct, also called a tear duct, is a pathway that allows tears to drain into the nose.

It is done to prevent excess tearing in the eye and to prevent the duct from becoming blocked or infected.

Tell a health care provider about:

• Any allergies your child has.
• All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Previous problems your child or members of your family have had with the use of anesthetics.
• Any blood disorders your child has.
• Any surgeries your child has had.
• Any medical conditions your child has.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• An allergic reaction to medicines used during the procedure.
• Bruising and swelling.
• Scarring in the tear duct.
• Bleeding or infection (rare).
• The procedure might not work effectively.

What happens before the procedure?

• Follow instructions from your child’s health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your child’s regular medicines. This is especially important if your child is taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your child’s blood. Do not give these medicines before the procedure if your child’s health care provider instructs you not to.
• Your child may be given antibiotic medicine to help prevent infection.
• Ask your health care provider how your child’s surgical site will be marked or identified.

What happens during the procedure?

• Your child will be given one or more of the following:
  • A medicine to help your child relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make your child fall asleep (general anesthetic).
• A thin, metal wire (probe) will be inserted into the nasolacrimal duct and moved down toward the opening of the nose.
• Another, wider probe may be used to gently open the duct.
• The duct will be flushed with a solution. This is done to make sure the duct has been opened.
• Eye drops or an ointment may be put in the eye.
• A patch may be put over the eye to protect the eye and to keep it clean.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your child will be taken to a recovery room.
• Your child may be groggy and may become nauseous.
• Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines he or she was given have worn off.

Nasolacrimal Duct Probing, Pediatric, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information on caring for your child after the procedure. Your child’s health care provider may also give you specific instructions. Your child’s treatment has been planned according to current medical practices, but problems sometimes occur. Call your child’s health care provider if your child has any problems or you have any questions after the procedure.

What can I expect after the procedure?

For 1–2 days after the procedure, your child may have:

• Eye pain.
• Fussiness.
• A feeling that there is something in his or her eye.
• A pink color or a small amount of blood in his or her tears.
• A small amount of blood in his or her nasal discharge.

Follow these instructions at home:

Eating and drinking

• If your child is breastfeeding or formula feeding, feed him or her as you normally would.
• If your child is older than 12 months and eating solid foods, offer your child clear liquids only for as long as told by his or her health care provider.

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Apply antibiotic eye drops or ointments as told by your child’s health care provider. Do not stop giving the antibiotic even if your child’s condition improves.
• Do not give your child aspirin because of the association with Reye syndrome.

Activity

• Keep your child calm.
• Have your child rest and play quietly for 1–2 days.
• Have your child return to regular activities slowly.

Other Instructions

• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child’s pain medicine does not seem to help.
• Your child’s pain gets worse.
• Your child has a fever.
• Your child has any of these symptoms for more than 2 days:
  • Eye pain.
  • Fussiness.
  • A feeling that there is something in his or her eye.
  • A pink color or a small amount of blood in his or her tears.
  • A small amount of blood in his or her nasal discharge.

Get help right away if:

• Your child’s eye is red or swollen.
• Your child has eye or nasal discharge that is green or yellow.
• Your child has tears or nasal discharge that is red (not pink).
• Your child has trouble seeing.
• Your child’s eye pain or fussiness gets worse.
• Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.
• Your child who is older than 3 months has a fever and symptoms that last more than 72 hours.