Name of the Condition

• Acquired Stenosis of Unspecified Nasolacrimal Duct

Summary

• Acquired stenosis of the nasolacrimal duct is a condition where the duct that drains tears from the eye into the nasal cavity becomes narrowed or blocked over time, which can lead to excessive tearing or infections due to the lack of proper drainage.

Causes

• The condition may be caused by chronic inflammation due to infection, trauma to the nasal or facial area, aging, or certain systemic diseases like sarcoidosis or Wegener's granulomatosis. Occasionally, prolonged use of certain medications or treatments can lead to stenosis.

Risk Factors

• Risk factors include advanced age, previous nasal or sinus surgeries, chronic allergies, and repeated eye infections. People with systemic diseases that affect mucous membranes are also at an increased risk.

Symptoms

• Common symptoms include persistent tearing (epiphora), recurrent eye infections, redness of the eye, and swelling near the inner corner of the eyelid.

Diagnosis

• Diagnosis typically involves a physical examination, nasolacrimal duct probing, or imaging studies such as a dacryocystogram or CT scan to evaluate the blockage's extent and location.

Treatment Options

• Treatments may include probing and irrigation of the duct, dacryocystorhinostomy surgery to create a new drainage pathway, balloon dacryoplasty to open narrow ducts, or the use of topical antibiotics or steroids to reduce inflammation.

Prognosis and Follow-Up

• With proper treatment, the prognosis is generally good, and most patients experience relief from symptoms. Follow-up care is important to ensure the duct remains open and to manage any underlying conditions that could contribute to recurrence.

Complications

• If untreated, complications can include recurrent eye infections, development of dacryocystitis (infection of the lacrimal sac), or even cellulitis in severe cases.

Lifestyle & Prevention

• Maintaining good eye hygiene, managing allergies appropriately, and avoiding injury to the facial area can help prevent nasolacrimal duct issues. For those with chronic eye conditions, regular consultations with an ophthalmologist may help prevent stenosis.

When to Seek Professional Help

• Seek medical advice if experiencing persistent tearing, recurring eye infections, or any pain or swelling around the eyes, which could indicate blocked tear drainage requiring professional evaluation.

Additional Resources

• American Academy of Ophthalmology: aao.org
• National Eye Institute: nei.nih.gov

Tips for Medical Coders

• Ensure to specify the acquired nature of the stenosis and use the correct code (H04.559) for an unspecified location of the nasolacrimal duct blockage. Avoid common errors such as confusing congenital with acquired conditions or misidentifying the duct’s laterality.