Flashcards in Lacrimal (M1) Deck (13)
Problems with what areas are considered external disease leading to epiphora?
2. ocular surface
4. inferior tear prism
What makes up the upper system of the nasolacrimal duct?
4. lacrimal sac
What makes up the lower system of the nasolacrimal duct?
1. lacrimal sac
2. valve of Hasner
What lid margin abnormalities can cause epiphora?
2. lid laxity
What punctal obstructions can cause epiphora?
2. large caruncle
If a patient is having epiphora and their drainage system is completely open what is the most likely cause?
dry eye (reflex tearing)
What is to be expected while probing the nasolacrimal duct if there is an obstruction?
soft stop (tissue stoping flow)
While probing the nasolacrimal duct, if there is regurgitation from the opposite canaliculus what does it indicate?
1. patency of opposite canalicular system
2. common canalicular block
3. lower system block in either lacrimal sac or nasolacrimal duct
What does the Dye disappearance test (DDT) consist of? 1. What determines if there is a blockage? 2
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
What is the value during the Shirmer test that indicates epiphora?
>10mm in 5 minutes
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
1. Instill fluorescein and inspect nose for dye
2. Means hypersecretion and has fluorescein in tissue
3. Means obstruction and doesn't have fluorescein
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
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