Case description: A yearling Thoroughbred stallion and an 8-year-old Saddlebred mare were evaluated for persistent mucoid ocular discharge.
Clinical findings: Examination of both horses revealed copious yellow-tan mucoid ocular discharge with a negative Jones I test, absent nasal punctum, and unsuccessful anterograde nasolacrimal duct (NLD) irrigation. Clinical abnormalities were present on the right side only in one horse and bilaterally in the other. Computed tomography (CT) with contrast confirmed nasolacrimal duct atresia in both horses.
Treatment and outcome: Under general anesthesia, the affected NLD was catheterized anterograde and contrast injected. Using fluoroscopic guidance, retrograde access to the distal NLD was obtained for through-and-through wire access. Over the wire, the stoma was dilated and a temporary stent placed for 4-8 weeks. After the procedure, both horses were comfortable and free of ocular discharge at the minimum time of last follow-up, 9 months postoperatively.
Clinical relevance: Fluoroscopically guided neocanalization is a viable alternative to traditional surgical approaches for NLD atresia, especially when access to the site of obstruction is limited.
Keywords: atresia; dacryocystorhinography; fluoroscopy; nasolacrimal duct; neocanalization; punctum.
© 2019 American College of Veterinary Ophthalmologists.