When initial conservative care has not resolved a neonatal dacryocystocele, a more active approach is indicated. This protocol addresses the uninfected dacryocystocele — a visible blue mass in the skin overlying the lacrimal sac — that has failed to clear with first-line measures.
Dacryocystoceles result from distention of the lacrimal sac, producing a visible blue mass in the skin overlying the lacrimal sac. The lesion is uninfected and is not causing respiratory compromise, yet has not responded to conservative management.
Initial conservative treatment — warm compresses, topical antibiotics, and digital pressure over the mass — was attempted, with the goal of achieving resolution of the dacryocystocele lesion. Because the lesion has not resolved, this next-line protocol is applied.
Management at this stage may involve systemic antibiotic therapy. Beyond that, procedural intervention — including lacrimal probing — is among the approaches employed, with more definitive options available when initial procedures are insufficient. The complete evidence-based sequence is available in the full protocol.