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Nasolacrimal duct probing may be performed in the office setting (usually from 4 to 8 months of age) or under general anesthesia in an operating room for older patients. The success rate of probing is higher for younger children. A silastic tube or stent may be employed along with probing to maintain tear duct patency. [6]
Dacryoscintigraphy (DSG), also known as lacrimal scintigraphy, is a nuclear medicine technique for imaging the lacrimal apparatus. It is used to identify obstructions, for example in the lacrimal duct , nasal cavity or nasolacrimal duct .
Bowman's lacrimal probe: probing the nasolacrimal duct: Lens expressor: used to force out the lens in extracapsular or intracapsular cataract extraction McNamar's spoon: used to force out the lens in intracapsular cataract extraction Iris repositor: two limbed instrument used to remove the iris during posterior chamber maneuvers
Punctal irrigation is also required. In infants with nasolacrimal defects, a nasolacrimal duct probe is used and a tube replacement, either temporary (Crawford) or permanent (Jones), is carried out. A surgical procedure called a dacryocystorhinostomy is done to join the lacrimal sac to the nasal mucosa in order to restore lacrimal drainage.
The canal containing the duct is called the nasolacrimal canal.It is formed by indentations in the inferior nasal conchae, maxilla and lacrimal bone.The canal drains into the nasal cavity through the anterior portion of the inferior meatus, which is between the inferior concha and the floor of the nasal cavity.
With the advent of nasal endoscopes, endoscopic dacryocystorhinostomy is becoming popular. In this procedure, a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. The bone covering the lacrimal sac is nibbled out. The medial wall of the sac is incised or excised, facilitating drainage of tears into the nasal cavity.
Canaliculodacryocystostomy is a surgical correction for a congenitally blocked tear duct in which the closed segment is excised and the open end is joined to the lacrimal sac. [33] [36] Canaliculotomy involves slitting of the lacrimal punctum and canaliculus for the relief of epiphora [33] A dacryoadenectomy is the surgical removal of a ...
The lacrimal punctum (pl.: puncta) or lacrimal point is a minute opening on the summits of the lacrimal papillae, seen on the margins of the eyelids at the lateral extremity of the lacrimal lake. There are two lacrimal puncta in the medial (inside) portion of each eyelid. Normally, the puncta dip into the lacrimal lake.