Office probing is safe and effective for treating congenital NLDO. The success rate of primary probing decreases significantly with age.

PurposeTo investigate the relationship between the morphologic features of myopic optic nerve head (ONH) and visual field (VF) defects in myopic subjects with primary open-angle glaucoma (POAG) by intraindividual comparison.MethodsMyopic POAG subjects with unilateral glaucomatous VF defect were recruited. The morphologic features of myopic ONH, including optic disc tilt, optic disc rotation, and β-zone parapapillary atrophy (PPA) were measured from color fundus photographs. The comparisons were performed between the eyes with VF defects and the contralateral eyes without VF defects. Logistic regression analysis was performed to investigate the relationship between various ocular parameters and the presence of VF defects.ResultsWe retrospectively included 100 eyes of 50 myopic POAG subjects. (Mean age: 50.1 ± 10.0 years). The tilt ratio was similar between the paired eyes. The degree of optic disc rotation (12.96 ± 7.21°) in eyes with VF defects were statistically greater than the contralateral eyes (6.86 ± 4.30°; P < 0.001) without VF defect. The β-zone PPA-to-disc area ratio was significantly greater in eyes with VF defects than the contralateral eyes (P = 0.024) without VF defect. In multivariate logistic regression analysis, the greater degree of optic disc rotation was significantly associated with the presence of VF defects (P < 0.001). However, tilt ratio, β-zone PPA-to-disc area ratio, refractive error, and axial length were not associated with the presence of VF defects.ConclusionsAmong the morphologic features of myopic ONH, only the greater degree of the optic disc rotation was associated with the presence of VF defects in myopic subjects with POAG.

We report two cases of preseptal cellulitis secondary to pediatric acute dacryocystitis (PAD) caused by congenital nasolacrimal duct obstruction (CNLDO).Case 1 was a 6.5-year-old girl without systemic diseases. She suffered from bilateral epiphora and mucoid discharge since birth. She had a history of PAD-related preseptal cellulitis twice and was admitted to another hospital twice for systemic antibiotic administration. Microbiological culture showed Haemophilus influenzae and Streptococcus pyogenes on different hospital admissions, respectively. Computed tomography outlined the abscess cavity in the lacrimal sac with increased density over the periocular area (Fig. 1).One week after discharge, she was brought to our outpatient department. Visual acuity and ocular movements were unaffected. Ocular examination showed positive die disappearance test (DDT) on both eyes. Right upper punctal occlusion was found under slit-lamp microscopy, and irrigation through the lower punctum demonstrated total obstruction with mucopurulent backflow. Probing