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August 1986

'Probing and Irrigation for Congenital Nasolacrimal Duct Obstruction'-Reply

Arch Ophthalmol. 1986;104(8):1125-1126. doi:10.1001/archopht.1986.01050200031022

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In Reply.  —I appreciate Dr Mittelman's interest in my article "Probing and Irrigation for Congenital Nasolacrimal Duct Obstruction" in the March 1985 Archives. Dr Mittelman would like to recommend probing for his patients before age 11 months, and, in practice, I usually do the same, give or take a month. The rate of spontaneous clearing of congenital nasolacrimal duct obstruction drops to a low level after age 1 year and continued tearing and discharge are unpleasant for patients and their parents. Hence, I offer to probe to clear a symptomatic illness.The issue of whether probing before age 11 months results in a higher rate of cure than probing after that time, is another matter that is not conclusively settled by Dr Mittelman's data, or mine. In neither study were patients assigned to early or late probing in a random fashion. Because of the high rate of spontaneous remission in

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