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Introduction: Congenital nasolacrimal duct obstruction (CNLDO) represents the most frequent cause of persistent epiphora in infancy and is estimated to affect approximately 5–20% of newborns.¹,² The majority of cases resolve spontaneously within the first year of life; however, persistent obstruction requires intervention, with probing remaining the standard initial surgical approach.²,³ Objective This study aims to compare the clinical outcomes of endoscopic-guided probing and conventional blind probing in the management of CNLDO. Results The reported success rates for blind probing vary between 70% and 90%, depending on patient age and disease complexity. In contrast, endoscopic-guided probing consistently demonstrates higher success rates ranging from 90% to 98%, particularly in older children and in cases of prior failed probing.⁴–⁶ The addition of direct visualization reduces the likelihood of false passage formation and improves anatomical accuracy during the procedure.⁶,⁷ Conclusion Endoscopic-guided probing represents a significant advancement in selected cases of CNLDO, particularly in complex or recurrent disease. Nevertheless, conventional blind probing continues to remain an effective and widely accepted treatment modality for uncomplicated early presentations.¹,³,⁵.
Congenital nasolacrimal duct obstruction is widely recognized as the most common congenital anomaly of the lacrimal drainage system.¹ Conservative treatment remains the first-line approach during infancy and typically includes Crigler massage, along with topical antibiotics when clinically indicated.⁸,⁹ However, after 12-18 months of age, the condition becomes less responsive to massage alone, with probing being the next step in the plan of management, which can be performed via a blind or endoscopically guided approach. This article reviews the pros and cons of both approaches.
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