title: A survey of management of congenital nasolacrimal duct obstruction by pediatric primary health care providers in Spain.
abstract: OBJECTIVE
  To survey the management of congenital nasolacrimal duct obstruction (CNLDO) by pediatric primary health care providers in Spain.
  
  
  METHODS
  This was a descriptive study using a web-based questionnaire to evaluate the perceptions of the members of the Pediatric Primary Care Society in Castilla-León, Spain (APAPCYL), regarding management of CNLDO. The questionnaire contained 14 direct questions and was sent by e-mail to all the pediatricians. All the responses were analyzed by the frequency of occurrence and percentages.
  
  
  RESULTS
  Ninety physicians responded to the questionnaire. Massage 2 or 3 times a day was the initial treatment advised by 60.47% of pediatricians. Nearly half of the pediatricians recommended continuing massage until symptoms resolved. Fewer than 50% of children required referral to an ophthalmologist. Reasons for an ophthalmic consult included persistence of symptoms among 87.21% of pediatricians and parental/guardian request among 10.5% of pediatricians. According to 45.6% of pediatricians, their knowledge about CNLDO is limited, and 92.2% would like to receive further training on CNLDO.
  
  
  CONCLUSIONS
  Massage was the main initial treatment for managing CNLDO among pediatricians. The outcomes of this survey indicated that massage fails in fewer than 50% of patients and an ophthalmic referral is required for these cases.
authors.affiliation: King Khaled Eye Specialist Hospital, Riyadh - Saudi Arabia.|Department of Ophthalmology, Complejo Asistencial de Palencia, Palencia - Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Galindo-Ferreiro
authors.affiliation: Primary Health Care Pediatric Center Cuellar, Segovia - Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Palencia-Ercilla
authors.affiliation: Department of Ophthalmology, Faculdade de Medicina de Botucatu-UNESP, São Paulo - Brazil.
authors.forename: Livia Mendoza
authors.initials: LM
authors.lastname: Ferreira
authors.affiliation: King Khaled Eye Specialist Hospital, Riyadh - Saudi Arabia.
authors.forename: Alberto
authors.initials: A
authors.lastname: Galvez-Ruiz
authors.affiliation: Distance Education and Health Information Technology Center, Faculdade de Medicina de Botucatu-UNESP, Sao Paulo - Brazil.
authors.forename: Denise C M
authors.initials: DCM
authors.lastname: Zornoff
authors.affiliation: Diagnostic Research, King Khaled Eye Specialist Hospital, Riyadh - Saudi Arabia.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Khandekar
authors.affiliation: Department of Ophthalmology, Faculdade de Medicina de Botucatu-UNESP, São Paulo - Brazil.
authors.forename: Silvana A
authors.initials: SA
authors.lastname: Schellini
mesh_terms: D002648:Child; D003608:Dacryocystorhinostomy / Q000706:statistics & numerical data; D019468:Disease Management; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007440:Intubation / Q000706:statistics & numerical data; D007767:Lacrimal Duct Obstruction / Q000151:congenital* / Q000628:therapy*; D008297:Male; D008405:Massage / Q000706:statistics & numerical data; D009301:Nasolacrimal Duct / Q000002:abnormalities*; D009885:Ophthalmology / Q000706:statistics & numerical data; D010372:Pediatrics / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013030:Spain