Lacrimal (M1) Flashcards

1
Q

Problems with what areas are considered external disease leading to epiphora?

A
  1. lids
  2. ocular surface
  3. lashes
  4. inferior tear prism
  5. puncta
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2
Q

What makes up the upper system of the nasolacrimal duct?

A
  1. external
  2. puncta
  3. canaliculi
  4. lacrimal sac
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3
Q

What makes up the lower system of the nasolacrimal duct?

A
  1. lacrimal sac

2. valve of Hasner

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4
Q

What lid margin abnormalities can cause epiphora?

A
  1. ectropion
  2. lid laxity
  3. entropion
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5
Q

What punctal obstructions can cause epiphora?

A
  1. conjunctivochalasis

2. large caruncle

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6
Q

If a patient is having epiphora and their drainage system is completely open what is the most likely cause?

A

dry eye (reflex tearing)

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7
Q

What is to be expected while probing the nasolacrimal duct if there is an obstruction?

A

soft stop (tissue stoping flow)

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8
Q

While probing the nasolacrimal duct, if there is regurgitation from the opposite canaliculus what does it indicate?

A
  1. patency of opposite canalicular system
  2. common canalicular block
  3. lower system block in either lacrimal sac or nasolacrimal duct
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9
Q

What does the Dye disappearance test (DDT) consist of? 1. What determines if there is a blockage? 2

A
  1. one drop of 2% fluorescein in both eyes and compare. 5-10 minute clearance then look
  2. If one eye has more in the eye it may be blocked
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10
Q

What is the value during the Shirmer test that indicates epiphora?

A

> 10mm in 5 minutes

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11
Q

What is the process involved in the Jones I Test of Epiphora? 1. What does a positive test mean and how does it appear? 2. Negative test? 3

A
  1. Instill fluorescein and inspect nose for dye
  2. Means hypersecretion and has fluorescein in tissue
  3. Means obstruction and doesn’t have fluorescein
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12
Q

What is the process involved in the Jones II Test of Epiphora? 1. What does a positive test mean and how does it appear? 2. Negative test? 3

A
  1. Rinse out fluorescein from Jones I, dilate/irrigate, and inspect for dye
  2. partial obstruction in lower portion of nasolacrimal duct; has dye
  3. partial canalicular/punctum obstruction in upper portion; no dye present
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13
Q

What is the treatment that creates a hole in the lacrimal sac to the medial nasal meatus?

A

Dacryocystorhinostomy

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