Emory Eye Center Starts Study for Infants with Blocked Tear Ducts

Highlights:

• No consensus exists on the optimal time to treat congenital nasolacrimal duct obstruction with nasolacrimal duct probing.
• Study researchers will determine whether there is any advantage to early probing, since many of these obstructions go away on their own.
• Researchers will determine the percentage of infants’ eyes that have resolution on their own by looking at the group that will receive no immediate probing.

Emory Eye Center will participate in third phase of a National Eye Institute (NEI)-sponsored multicenter clinical trial, the Nasolacrimal Duct Obstruction (NLDO) Study in late winter. The trial will evaluate which of two approaches is optimal in treating young infants with blocked tear duct: probing the obstruction immediately or waiting to see if the condition goes away on its own after six months, as is often the case.

Co-investigators Amy Hutchinson, MD, and Scott Lambert, MD, pediatric ophthalmologists, will enroll the first patients this spring. Infants must be between six and 10 months old. Half the group of children eligible for enrollment in the study will undergo immediate probing. The other half will wait six months for probing. The later group may receive eye massage at home, which in itself can be helpful.

An antibiotic eye drop may also be prescribed if necessary. At six months, if the obstruction persists, probing will be done within a month. Assignment to either of the two groups is randomly picked via computer.

“This trial will give important information that will help physicians provide the best, safest and most cost effective treatment to children with this very common disorder,” says Hutchinson.

“Doctors are trying to find the most cost-effective ways to treat diseases,” says Lambert. “This study should help us better understand where it is more cost-effective to treat blocked tear ducts during infancy or to wait until children are older.”

NLDO is common in infants and toddlers and presents in the first few months of life. It is caused by a blockage of the duct that drains the tears from the eye to the nose. NLDO often goes away on its own, but when it does not, the condition is often treated with a procedure called probing.

During probing, the physician passes a probe through the tear duct, typically clearing the blockage. In children one year and older, the procedure is performed in a hospital or surgery center using anesthesia. In children less than a year old, some doctors will perform the procedure in the office without putting the child to sleep.

More than 220 children will participate in the study throughout the country. The study is a part of the Pediatric Eye Disease Investigator Group of NEI of the National Institutes of Health. The NEI provides funding for the study.

The Department of Ophthalmology and Emory Eye Center have a mission to conduct pioneering research into blinding eye diseases, to educate and train eye professionals, and to provide excellent patient care. The Department includes 35 ophthalmologists, seven optometrists, nine basic scientists, 11 post-doctoral fellows, and nine researchers in other Emory departments who hold joint appointments in the Department of Ophthalmology. Ophthalmology research is supported by $6 million in NIH funding. The Department remains in the top rankings (#9 – 2008) by U.S. News & World Report for the 12 years the magazine has held a ranking for Ophthalmology. It also ranks in the Top Ten in all four categories surveyed by Ophthalmology Times annual report. http://eyecenter.emory.edu
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