: If the area becomes significantly red, hot, or swollen, or if the eye itself becomes red, contact a healthcare provider as this may indicate dacryocystitis (an infection of the sac).
The goal is to create hydrostatic pressure within the drainage system. For infants, doctors often recommend performing this three times a day (e.g., at morning, noon, and night).
For acquired NLDO in adults (e.g., involutional stenosis), lacrimal duct massage is less effective due to fibrotic or bony changes; probing or dacryocystorhinostomy (DCR) surgery is typically required.
While many cases resolve spontaneously within the first year of life, intervention is often required. Traditional management has progressed from observation to probing, intubation, or balloon dacryoplasty. However, prior to invasive procedures, lacrimal duct massage—first described by Crigler in 1923—remains the cornerstone of conservative management. This paper explores the biomechanical principles, proper execution, clinical evidence, and role of lacrimal duct massage in contemporary ophthalmic practice.