Dilation Irrigation & Punctal Plugs Flashcards
When is lacrimal dilation & irrigation performed?
When a patient comes in complaining of epiphora
Epiphora is typically caused by ____
a functional blockage within the lacrimal excretory system
What will lacrimal dilation & irrigation determine?
the patency of the system & localize the obstruction
What are some causes of epiphora?
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
What are the measurements of the inferior canaliculus?
2mm and 8mm
The inferior canaliculus contains ____% of tears
70%
The superior canaliculus contains ____% of tears
30%
How long is the lacrimal sac?
10mm long
What are other tests to assess epiphora?
assess puncta
fluorescein dye disappearance test
fluorescein dye appearance test (jones dye test)
How do you assess the puncta?
look at positioning and compress nasolacrimal sac
What is the purpose of the Fluorescein Dye Disappearance Test?
to determine the amount of dye retention in the lacrimal lake
What is the purpose of the Fluorescein Dye Appearance Test (Jones Dye Tests)?
to assess the drainage of the lacrimal excretory system
What does a hard stop indicate?
there is not a complete obstruction in the canalicular system
What does a soft stop indicate?
the cannula is being prevented from entering the lacrimal sac, so there is a blockage of the canlicular system
When are punctal plugs indicated in the treatment of dry eyes?
when ocular signs and symptoms are not acceptably relieved with artificial tears/ointments
