OBSTRUCTION OF THE LACRIMAL DRAINAGE SYSTEM

Question 1

caused by a membrane blocking the valve of Hasner at the nasal side of NLD

Answer 1

congenital nasolacrimal duct obstruction

Question 2

______% of all symptomatic congenital NLD obstructions resolve in the first year of life.

Answer 2

90

Question 3

True or False: In Congenital Nasolacrimal Duct Obstruction, One-half has bilateral involvement

Answer 3

False; One-third

Question 4

Congenital Nasolacrimal Duct Obstruction is evident in only __________ of full-term infants at 3-4 weeks of age

Answer 4

2%-6%

Question 5

Management options for Congenital Nasolacrimal Duct Obstruction

Answer 5

Conservative and Surgical

Question 6

Conservative (nonsurgical) management options of congenital nasolacrimal duct obstruction

Answer 6

observation
lacrimal sac massage
topical or even orbital antibiotics

Question 7

dacryocystocele is also called

Answer 7

amniotocele

Question 8

(Dacryocystocele) Mucocele present in

Answer 8

lacrimal sac distension

Question 9

dacryocystocele is present at ________ or may develop within __________ weeks after birth

Answer 9

birth; 1 to 4

Question 10

dacryocystocele occurs when the NLD is obstructed and ________ or mucus (secreted by _____________) is trapped in the _________ because of a functional block above the sac and a block or atresia at the lower end of the NLD

Answer 10

amniotic fluid; lacrimal sac goblet cells; tear sac

Question 11

management of dacryocystocele

Answer 11

Prophylactic topical antibiotics
Lacrimal Sac Massage
Probing of the Lacrimal Sac
-no response in 1-2 weeks
-if infection develops
Excision or marsupialization of the prolapsed duct

Question 12

(Dacryocystocele) Airway Obstruction - urgent treatment may be needed if the condition is ________

Answer 12

bilateral

Question 13

concentration form in the lacrimal sac

Answer 13

Dacryolith

Question 14

Shed epithelial cells, lipids, and amorphous debris wit or without calcium

Answer 14

Dacryolith

Question 15

Signs and Symptoms of Dacryolith

Answer 15

Lacrimal Sac Distension
Substantial pain

Question 16

often occurs with conjunction and may contribute to the development of NLDO

Answer 16

Sinus Disease

Question 17

True or False: (Sinus Disease)
The clinicians should inquire about the previous refractive surgery

Answer 17

False; PREVIOUS SINUS SURGERY

Question 18

True or False: NLD is sometimes inadvertently damaged during sinus procedure

Answer 18

True

Question 19

Causes of Lacrimal Trauma

Answer 19

Rhinoplasty
Endoscopic Sinus Surgery
Naso-orbital fracture

Question 20

What is the inflammatory disease that leads to NLDO:

Answer 20

Lethal Midline Granuloma
Polyangiits (Wegener Granulomatosis)
Granulomatosis
Sarcoidosis

Question 21

it is used to keep the eye moist after having refractive surgery

Answer 21

Lacrimal Plugs/ Punctal Plugs

Question 22

(Lacrimal Plugs)
dislodged _______ and _________ ________ can migrate to and occlude the NLD

Answer 22

punctal; canalicular plugs

Question 23

(Lacrimal Plug)
remaining segments of a partially removed _______ _______ have also been known to cause NLDO

Answer 23

silicone stent

Question 24

(Radioactive Iodine)
Therapeutic radioactive iodine for the treatment of ___________ may also lead to the closure of the ___________ __________

Answer 24

thyroid cancer; lacrimal apparatus

Question 25

(Radioactive Iodine) 2 specific lacrimal apparatus that is affected

Answer 25

Lacrimal Sac
Lacrimal Duct

Question 26

What are the 8 obstructions of Lacrimal Drainage

Answer 26

-Congenital Nasolacrimal Duct Obstruction
-Dacryocystocele
-Dacryolith
-Sinus disease
-Trauma
-Inflammatory Disease
-Lacrimal Plugs/ Punctal Plugs
-Radioactive Iodine