A 50-year-old woman presents with chronic unilateral epiphora and a non-tender swelling below the medial canthal tendon for 6 months. Pressing over the swelling produces mucopurulent reflux from the lower punctum. The MOST appropriate definitive treatment is:
- A Dacryocystorhinostomy ✓
- B Balloon dacryoplasty
- C Topical antibiotic drops
- D Conjunctivodacryocystorhinostomy
Correct answer: A. Dacryocystorhinostomy
Explanation
This presentation is classic for chronic dacryocystitis with mucocele formation due to nasolacrimal duct obstruction. Dacryocystorhinostomy (DCR) is the definitive treatment, creating a fistula between the lacrimal sac and nasal mucosa to bypass the obstruction. Conjunctivodacryocystorhinostomy with Jones tube is reserved for canalicular obstruction or failed DCR. Balloon dacryoplasty is used for partial stenosis, not complete obstruction.
Reference: AAO Basic and Clinical Science Course, Section 7: Orbit, Eyelids, and Lacrimal System, 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.