Lacrimal Apparatus Flashcards
Parts of lacrimal apparatus
Lacrimal gland Canaliculi Punctum Lacrimal sac Rose muller valve Nasilacrimal duct Krausse Hasner valve
Parasympathetic parts of lacrimal apparatus
Salivary nucleus
Sphenopalatine ganglion
Lacrimal gland
Nerve for tear secretion
Greater Superficial petrosal nerve (branch of facial nerve)
What could be the etiology of watering eye
Hyperlactimation
Partial obstruction of lacrimal pathway
Total obstruction of lacrimal pathway
Lacrimal pump failure
Jones dye test 1 and test 2
Jones dye test 1 - fluoroscein dye in eye
Cotton bud in nose
D+/D-
Jones dye test 2-
Saline in lacrimal sac
Dye in eye
Know the result of each etiology
What is dactocystography
To know the exact location of obstruction
Lacrimal scintigraphy
For lacrimal pump failure
Radionucleotide injected into blood
Comes to eye
Lacrimal pathway
Features of NLD obstruction
Epiphora
Dactocystitis
Regurgitation test +
On bowman probing hard stop
Complications of acute dactocystitis
Mucocele
Lacrimal fistula
Chronic dactocystitis
Orbital cellulitis
Features of canalicular obstruction
Epiphora
Regurgitation test -
On bowman probing -soft stop
Treatment of congenital NLD obstruction
Less than 9 months - criggler massage
9month-4yrs - bowman probing
> 4yr - DCR (opening in middle meatus)
MC obstruction in congenital NLD obstruction
Hasner valve
Contraindications for DCR
- < 4yrs
- Acute dactocystitis (chances of spread)
- fibrosed lacrimal sac (dacrocystectomy is done)
- malignancy of lacrimal sac
Sex predilection for chronic NLD obstruction
Females (anatomy of NLD is narrower)
MC common lacrimal gland tumour
Pleomorphic adenoma aka benign mixed tumour
