1. Lacrimal System

2. Baby picture of the day!

4. 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)

5. Dacryocystitis Infection of the lacrimal sac
Obstruction of drainage causes backflow of bacteria into eye
Swelling
No surgery!

6. Canaliculitis Inflammation of canaliculi
Pouting puncta, mucopurulent discharge with palpation

7. Punctal Stenosis
Narrowing/occlusion of puncta
Cause: age
Epiphora

8. Nasolacrimal Duct Obstruction
Infants:
Adults:
Membrane blocking the valve of Hasner
Unilateral tearing
Involutional stenosis (disease or trauma)
Unilateral tearing

9. 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)

10. 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