Non-surgical Iranian Traditional Medicine-Based Treatment of Chronic Refractory Congenital Nasolacrimal Duct Obstruction in a Surgical Candidate (Thirteen-Months-Old) Infant
AbstractCongenital or acquired obstruction is the most common anomaly of nasolacrimal duct (NLD). NLD obstruction (NLDO) is one of the most common problems in pediatric ophthalmology. Some symptoms of NLDO are seen in 6-20% of infants. NLDO creates two problems; first is disruption in the flow of tears that is due to epiphora. Another is the infection leading to stasis of fluid in the lacrimal system. Surgery is the choice treatment of chronic congenital NLDO in the refractory infants to massage and antibiotics. Dam-e is a watery discharge of eyes that has different reasons in Persian Medicine (PM). Based on the symptoms which was seen in patients with NLDO, it could be one of the subgroups of Dam-e. Conforming to Persian Medicine, residue of materials that moves from brain to the eyes and sediments in the NLD, can be the main reason of NLDO. Our case is the thirteen-month-old infant with congenital NLDO unresponsive to antibiotics and massage and has been a candidate for surgery. In PM view, to open the lacrimal duct obstruction, we use the properties of Persian Medicine’drugs (including Honey, camphor, vinegar and sesame oil) such as fragmentation of excreta (are Moghatte in PM), anti- obstruction (Mofatteh in PM), cleansing (Monaghi in PM) and descaling (Jali in PM) effects, and the patient's symptoms were nonsurgically relieved. In the discussion of this paper, the properties of these drugs also check point of view of contemporary medicine’s viewpoints compared to Persian Medicine.
Jeffrey JH. The Lacrimal Drainage System. In: Ophthalmology. Eds, M Yanoff, JS Duker. Elsevier, China, 2014; pp 1346-1348.
Lueder GT. The association of neonatal dacryocystoceles and infantile dacryocystitis with nasolacrimal duct cysts. Trans Am Ophthalmol Soc 2012;110:74-93.
Lee KA, Chandler DL, Repka MX, Melia M, Beck RW, Summers CG. A comparison of treatment approaches for bilateral congenital nasolacrimal duct obstruction. Am J Ophthalmol 2013;156:1045-1050.
Shirazi EE. Kefaye Mansoori. 1st ed. Iran University of medical sciences. Tehran 2003; p 280.
Ojaghi H, Masoomi R, Mazaherigarangah N, Sagha M. Survay the results of nasolacrimal duct probing and related factors in children with congenital nasolacrimal duct obstruction in Alavi Hospital. Journal of Ardabil University of Medical Sciences 2004;5:213-219.
Biswarup R, Saumendra NB, Debabrata D, Bivas A. A rare cause of nasolacrimal duct obstruction: Dentigerous cyst in the maxillary sinus. Indian J Ophthalmol 2009;57:465-467.
Sina I. Al-Qanun fi Tibb. 1st ed. Al-Alami Library. Beirut 2005; pp 379-380.
Arzani M. Tebbe Akbari. 1st ed. Jalal-aldin. Tehran 2008; pp 217-219.
Sadati SN, Shams Ardekani MR, Ebadi N, Yakhchali M, Raees Dana A, Masoomi F, Khanavi M, Ramezany F .Review of scientific evidence of medicinalconvoy plants in Traditional Persian Medicine. Pharmacogn Rev 2016;10:33-38.
Aghili MH. Makhzan-al,-advieh. 2nd ed. Sabzaarang. Tehran 2011; pp 70-71, 469, 545-546, 649-650.
Majtanova N, Cernak MA, Majtan J. Honey: a natural remedy for eye diseses. Forsch Complementa Med 2016;23:364-369.
Majtanova N, Vodrazkova E, Kurilova V, Horniackova M, Cernak M, Cernak A. Complementary treatment of contact lens-induced corneal ulcer using honey: A case report. Cont Lens Anterior Ey 2015; 38:61-63.
Velpandian T, Gupta P, Kumar Ravi A, Prasad Sharma H, Ranjan Biswas N. Evaluation of pharmacological activities and assessment of intraocular penetration of an ayurvedic polyherbal eye drop (Itone™) in experimental models. BMC Complem Altern Med 2013;13:1-12.
Lim GC, Chen YF, Liu L, Huang SC, Lin KK, Hsiao CH. Camphor-related self-inflicted keratoconjunctivitis complicating delusions of parasitosis. Cornea 2006;25:1254-1256.
Mas A, Jesús Torija M, Carmen García-Parrilla M, Troncoso AM. Acetic Acid Bacteria and the Production and Quality of Wine Vinegar. Sci World J 2014;394671
Hanus J, Zhang H, Chen DH, Zhou Q, Jin P, Liu Q, Wang S. Gossypol acetic acid prevents oxidative stress-induced retinal pigment epithelial necrosis by regulating the foxO3/sestrin2 pathway. Mol Cell Biol 2015;35:1952-1963.
Li C, Zhao T, Li C, Mei L, Yu E, Dong Y, Chen J, Zhub S. Determination of gossypol content in cottonseeds by near infrared spectroscopy based on Monte Carlo uninformative variable elimination and nonlinear calibration methods. Food Chem 2017;221:990-996.
Agarwal KN, Gupta A, Pushkarna R, Bhargava SK, Faridi MM, Prabhu MK. Effects of massage & use of oil on growth, blood flow & sleep pattern in infants. Indian J Med Res 2000;112:212-217.
Pediatric Eye Disease Investigator Group. Resolution of congenital nasolacrimal duct obstruction with nonsurgical management. Arch Ophthalmol 2012;130:730-734.
Karti O, Karahan E, Acan D, Kusbeci T. The natural process of congenital nasolacrimal duct obstruction and effect of lacrimal sac massage. Int Ophthalmol 2016;36:845-849.