Lacrimal System
Baby picture of the day!
Dacryoadenitis Inflammation of lacrimal gland Acute or chronic Signs: Swelling S-shaped ptosis Acute: Pain Redness Due to infection Chronic: due to inflammatory disorder (sarcoid, TB, Grave’s)
Dacryocystitis Infection of the lacrimal sac Obstruction of drainage causes backflow of bacteria into eye Swelling No surgery!
Canaliculitis Inflammation of canaliculi Pouting puncta, mucopurulent discharge with palpation
Punctal Stenosis Narrowing/occlusion of puncta Cause: age Epiphora
Nasolacrimal Duct Obstruction Infants: Adults: Membrane blocking the valve of Hasner Unilateral tearing Involutional stenosis (disease or trauma) Unilateral tearing
Jones I Testing Put fluorescein in the eye Wait 5 minutes Have patient blow nose or swab nose, check for fluorescein Positive test = patent system (so fluorescein should have made it to the nose)
Jones II “Dilation & Irrigation” Performed after a negative Jones I test, to see if system can be opened Irrigate with saline through puncta If D&I opens the drainage system, patient will gag or taste saline do Jones I again