Lacrimal Drainage System Flashcards
Epiphora
overflow of tears
Causes of Epiphora
lid position abnormalities ocular surface disorders/ irritation tear flow tract disfunctions infectious overproduction
Congenital Epiphora
Valve of Hasner not developed, tears cannot drain
Treating Congenital Epiphora
watchful waiting for first year, should open on its own
massaging of duct to accelerate
probing and stenting if still closed after 1 year
Dacrocystocele
congenital
filled with amniotic fluid or mucus since Valve of Hasner is closed
Dacrocystitis
infection of dacrocystocele
red
Treating Dacrocystitis
oral antibiotics
Chronic Dacrocystitis
asymptomatic other than some tearing
treat by clearing acute infection, then surgery
Conditions that can cause punctal occlusion
ectropian
drugs (cancer)
Conjunctochalasis
extra folds in conjunctiva
can flip over lid and cover puncta, causing epiphora
age related
Treating Conjunctochalasis
surgery to remove excess conjunctiva
Visualizing Conjunctochalasis
fluoroscein staining
Dacryolith
calcium block lodged in lacrimal drainage system
Treating Dacryolith
surgery to remove
Causes of Canalicular Obstructions
congenital
trauma
infection- HSV, chronic dacryocystitis
medication
Treating Canalicular Partial Obstructions
stenting and intubation
Treating Canalicular Complete Obstructions
obstruction near puncta can be excised
trephination, balloon canaliculoplasty, endoscopic laser; followed by stenting
Causes of Nasolacrimal Obstructions
trauma
surgery
tumors
Treatment of Nasolacrimal Obstructions
dacryocystorhinostomy
Jones Dye Test, 1 vs 2
dye applied with Q-tip
dye injected into puncta
both check to see if dye exits nose
Dacryocystography
imaging of drainage system