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Project Description

Please note that we are a research service provider, not a pharmacy or clinic, so we are unable to see patients and do not offer diagnostic and treatment services for individuals.

Congenital Nasolacrimal Duct Obstruction (CNLDO)

In children, Congenital Nasolacrimal Duct Obstruction (CNLDO) is a condition characterized by obstruction of the nasolacrimal duct drainage system which leads to epiphora or over-tearing. At Protheragen we provide extensive services for the diagnostics and therapeutics for CNLDO.

Overview of Congenital Nasolacrimal Duct Obstruction (CNLDO)

Congenital Nasolacrimal Duct Obstruction (CNLDO) is a paediatric nasolacrimal duct blockage disorder that causes excessive tearing with a possibility of mucous discharge. It usually results from obstructions located at the distal end of the nasolacrimal duct caused by a persistent membrane, bone deformities, or stenosis of the inferior meatus. Globally, CNLDO affects around 5% to 20% of infants and is more prevalent in premature infants.

Fig.1 Schematic representation of the right nasolacrimal duct. (Sasaki T., et al., 2024)

The CNLDO mechanism originates from obstruction which is distally situated in the nasolacrimal duct (NLD) at the Hasner valve. While most CNLDO cases spontaneously resolve in the first year of life, some patients face prolonged obstruction which could lead to distress in both children and parents.

Diagnostics Development for Congenital Nasolacrimal Duct Obstruction

Fluorescein Dye Disappearance Test (FDT)

The FDT is a non-invasive diagnostic method that measures the clearance of fluorescein dye from the tear meniscus. It possesses a sensitivity of 90% and a specificity of 100%, which makes it superior for the confirmation of lacrimal duct obstruction. The test employs a drop of fluorescein dye placed in the conjunctival sac and measures the time needed for the dye to disappear. Prolonged time needed for the dye to disappear is indicative of CNLDO.

Therapeutics Development for Congenital Nasolacrimal Duct Obstruction

Efficacy of Antibiotic Eyedrops
The application of antibiotic eye drops in the management of Congenital Nasolacrimal Duct Obstruction (CNLDO) has been studied by several authors. It has been demonstrated that there is little evidence in support of the use of eyedrops in conjunction with the spontaneous resolution of CNLDO.

Risks of Antibiotic Use
The application of antibiotic eye drops in infants raises even greater issues. Infants are too young and more susceptible to contracting resistant forms of the bacteria, which is why their underdeveloped immune systems cannot get rid of antibiotic-resistant strains of bacteria. As a result, infants can become hosts for antibiotic-resistant bacterial flora.

Indications for Antibiotic Use
Although there is a common opinion not to recommend the use of antibiotics in CNLDO routinely, there are particular circumstances where their use is warranted. Sometimes, antibiotic eyedrops are indicated in cases of conjunctivitis, which is often encountered at the same time with CNLDO.

Our Services

At Protheragen, we take pride in our comprehensive suite of services dedicated to advancing diagnostics and therapeutics of congenital nasolacrimal duct obstruction.

Diagnostics Development

Karyotype Analysis Service
Omics Analysis Service
Biomarker Development Service
Artificial Intelligence Service
Customized Diagnostics Development

Therapeutic Development

Small Molecule Drug
Cell Therapy
Gene Therapy
Therapeutic Antibody
Therapeutic Peptide
Therapeutic Protein
Customized Therapy Development

Disease Models

Surgical Mouse Models
Prickle1 Mutant Mouse Models
Self-Curing Resin Induced NLDO Rabbit Models
Bacterial Injection Rabbit Models

We provide a range of preclinical research services to support the development of CNLDO diagnostics and therapeutics. Our services include:

Animal Model Development: We develop and validate animal models of CNLDO to study the pathogenesis and test new therapeutic interventions.
In Vitro Studies: We conduct in vitro studies to investigate the cellular and molecular mechanisms underlying CNLDO and to screen potential therapeutic compounds.
Pharmacokinetics and Toxicology Studies: We perform comprehensive safety and pharmacokinetics testing of new diagnostics and therapeutics in preclinical models to ensure their safety and effectiveness before human trials.

If you are interested in our services, please feel free to contact us.

References

Sasaki, Tsugihisa, et al. "Congenital nasolacrimal duct obstruction: clinical guideline." Japanese Journal of Ophthalmology 68.4 (2024): 367-388.
Vagge, Aldo, et al. "Congenital nasolacrimal duct obstruction (CNLDO): a review." Diseases 6.4 (2018): 96.
Takahashi, Yasuhiro, et al. "Management of congenital nasolacrimal duct obstruction." Acta ophthalmologica 88.5 (2010): 506-513.