Risk factors for developing congenital nasolacrimal duct obstruction

Objective: To identify potential risk factors for developing congenital nasolacrimal duct obstruction (CNLDO). Study design and methods: A cross-sectional study. A quantitative questionnaire was distributed to a sample of mothers attending the Pediatrics Clinic at King Khalid University Hospital, Riyadh, Saudi Arabia. Results: A total of 756 mothers responded to our questionnaire. Of the 756 filled questionnaires, 389 (51.67%) were male children. 5.3% of the mothers lived in non-urban settings. CNLDO was reported in the children attending the clinic by 17.1% (129/756) of their mothers. Average age (±SD) of infants when persistent tearing was noticed was 3.2 ± 2.7 months, while average age (±SD) of resolution was 9.6 ± 3.7 months. Of the children with CNLDO, 37.2% (48/129) still have persistent tearing at the time of distributing the questionnaire. Among the group with CNLDO, 17% (22/129) of their mothers have experienced an infection during pregnancy (p = 0.022). Within the same group, 14.7% (19/129) of the affected children were reported by their mothers to have other children with CNLDO which was statistically significant (p = 0.001). Conclusion: CNLDO could have a genetic predisposition and maternal infection is a possible risk factor for developing CNLDO. Surgical management awareness should be emphasized to relieve children from this relatively common and benign condition.