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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
20222826
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I would like an opthamologist to answer my question. My almost

Resolved Question:

I would like an opthamologist to answer my question. My almost 2 year old daughter had tear duct probing and balloon dilation about 6 months ago. I had a few questions. She was symptomatic in one eye only, but the ped opthamologist probed and dilated both eyes because she said the asymptomatic eye had questionable obstruction and it could always become symptomatic later in life. Is it common during anesthesia, to probe both eyes even if only one is symptomatic? Also, now, every now and then when she is sick, the previously asymptomatic eye waters. Could this be from the procedure or could it just be normal mucous clogging duct? Thanks for your help.
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. James replied 5 years ago.

Dr. James :

Hello.

Dr. James :

did you consent to the probing of both sides?

Customer:

My husband and I are both physicians, and it made sense to us when the doctor said that while under general anesthesia with low risk, it would be a good idea to check both eyes because a mild obstruction could present later. So, yes we consented to both sides because it sounded like the standard of what usually was done.

Dr. James :

I can understand the argument for having both sides probed since your daughter would be under general anesthesia anyways.

Dr. James :

From my training, our practice was to probe only the symptomatic eye.

Dr. James :

In my practice, I don't do too many kids, but would the same in only probing the symptomatic side.

Dr. James :

Doing both sides, however, would not be unreasonable.

Dr. James :

Regarding your second questions, I don't believe the probing caused any ill-effects.

Dr. James :

Do you have any additional questions?

Customer:

Can mucous clog a normal tear duct that is not narrowed and cause the eye to water while sick?

Dr. James :

The tearing during sickness is likely due to temporary block of the nasolacrimal duct due to inflammation of the mucosal tissues.

Dr. James :

Mucous can clog it up as well.

Dr. James :

But these effects should be temporary only.

Dr. James :

hello?

Customer:

So, do you think it is all unrelated to probing and balloon dilation in the previously asymptomatic eye? We just do not want to go back to a physician that did an unnecessary procedure that now may be causing problems and we have a follow up soon.

Dr. James :

Yes, I believe it is unrelated.

Dr. James :

Certainly, you can go to another pediatric ophthalmologist for a second opinion.

Dr. James :

to evaluate if there is blockage however, he may recommend another probing.

Dr. James :

Was both sides balloon dilated?

Customer:

Yes. Both sides were balloon dilated. There was a distal obstruction on the symptomatic eye and a more mild mid obstruction on the asymptomatic side. Would balloon dilation be more likely to cause post op issues?

Customer:

The ped ophth always balloon dilates with probing because he thinks that it increases the success rate of the procedure.

Customer:

I just thought maybe if the asymptomatic side were dilated distally that mucous would be more likely to plug up the distal aspect of the duct.

Dr. James :

Yes, balloon dilation increases the success.

Dr. James :

Mucous has nothing to do with the success or failure of the procedure.

Dr. James :

I doubt the probing caused the current symptoms.

Customer:

Thank you!

Dr. James :

You're welcome. Please remember to press accept so I can get credit for assisting you today.

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