Lacrimal system examination
Richard C. Allen, MD, PhD, FACS
Additional Notes: Length 01:29
Evaluation of the lacrimal drainage system involves dilating the puncta first. The lower puncta is dilated with the punctal dilator. The dilator is placed vertical followed by horizontal. The same is done for the upper punctum, again passing the dilator vertical followed by horizontal.
The patency of the canaliculus is evaluated using a Bowman probe. Usually I will use a 0 Bowman probe. The probe is placed vertical followed by horizontal. The probe is placed along the length of the canaliculus to palpate for any evidence of obstruction or a soft stop. The same is done for the upper canaliculus.
A lacrimal cannula on a 3 cc syringe filled with saline is then used to evaluate the patency of the nasolacrimal duct. The lacrimal cannula is introduced into the canaliculus followed by irrigation with the saline. The patient should be able to taste the saline in the back of their throat if the nasolacrimal duct is not obstructed. The same can be done on the upper eyelid.
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December 19, 2016