Lacrimal Duct Massage ((exclusive)) -

Lacrimal Duct Massage: Techniques, Indications, and Evidence in the Management of Nasolacrimal Duct Obstruction

Lacrimal duct massage, Crigler massage, nasolacrimal duct obstruction, congenital epiphora, dacryocystitis 1. Introduction Nasolacrimal duct obstruction (NLDO) is the most common cause of persistent tearing (epiphora) and ocular discharge in infants, affecting approximately 5-20% of newborns (Schnall, 2023). The condition arises from the failure of the distal end of the nasolacrimal duct—the valve of Hasner—to spontaneously open during fetal development or shortly after birth. lacrimal duct massage

A landmark RCT by Kushner (1982) and a later meta-analysis by Petris and Liu (2017) found that . A landmark RCT by Kushner (1982) and a

Identify the medial canthus. The lacrimal sac is palpated as a small, firm nodule just medial to the inner canthal tendon. Perform hand hygiene

Perform hand hygiene. Trim fingernails. Position the infant supine or held securely by a parent.

If mucopurulent discharge is expressed, gentle cleaning with warm water or saline on a gauze pad should follow massage. 5. Clinical Evidence and Efficacy 5.1 Spontaneous Resolution Rates Multiple observational studies demonstrate that over 80% of congenital NLDO resolves by 12 months of age. The role of massage specifically—versus observation alone—has been debated.