Dilation Irrigation & Punctal Plugs Flashcards

1
Q

When is lacrimal dilation & irrigation performed?

A

When a patient comes in complaining of epiphora

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2
Q

Epiphora is typically caused by ____

A

a functional blockage within the lacrimal excretory system

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3
Q

What will lacrimal dilation & irrigation determine?

A

the patency of the system & localize the obstruction

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4
Q

What are some causes of epiphora?

A

punctal abnormality (35%) —stenosis

nasolacrimal duct abnormality (24%) — due to recurrent inflammation of mucosal lining or scarring

canalicular abnormalities (14.8%) — stenosis, injury, inflammation, infection & topical gtts

lacrimal pump problems — senile laxity, facial palsy

pseudoepihora — reflex tearing caused by inflammation & dry eye

nasal disease — allergic rhinitis, tumors, after rhinoplasty

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5
Q

What are the measurements of the inferior canaliculus?

A

2mm and 8mm

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6
Q

The inferior canaliculus contains ____% of tears

A

70%

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7
Q

The superior canaliculus contains ____% of tears

A

30%

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8
Q

How long is the lacrimal sac?

A

10mm long

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9
Q

What are other tests to assess epiphora?

A

assess puncta

fluorescein dye disappearance test

fluorescein dye appearance test (jones dye test)

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10
Q

How do you assess the puncta?

A

look at positioning and compress nasolacrimal sac

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11
Q

What is the purpose of the Fluorescein Dye Disappearance Test?

A

to determine the amount of dye retention in the lacrimal lake

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12
Q

What is the purpose of the Fluorescein Dye Appearance Test (Jones Dye Tests)?

A

to assess the drainage of the lacrimal excretory system

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13
Q

What does a hard stop indicate?

A

there is not a complete obstruction in the canalicular system

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14
Q

What does a soft stop indicate?

A

the cannula is being prevented from entering the lacrimal sac, so there is a blockage of the canlicular system

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15
Q

When are punctal plugs indicated in the treatment of dry eyes?

A

when ocular signs and symptoms are not acceptably relieved with artificial tears/ointments

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16
Q

What is considered the next line of treatment for patients with moderate/severe dry eyes?

A

punctal plugs

17
Q

Collagen punctal plugs typically dissolve within _____. Monitor their symptoms during this time frame, especially the first _____.

A

7-10 day; 3-5 days

18
Q

What type of punctal plugs can be considered if signs/symptoms improve?

A

reversible punctal plugs, or permanent punctal occlusion

19
Q

Collage punctal plugs block up to ____ of the punctal drainage so natural tears remin in the cul de sac.

A

80%