Tear ducts

Proper tear drainage protects the eye from infections. Any problem in the tear duct either at its onset at the tear points or at its end (the Hasner valve) causes patients to notice an increase in tearing and may be more likely to have conjunctivitis.


For the correct evaluation of the tear duct, a visit with the oculoplastic ophthalmologist is necessary for a syringing test, this test is performed at the consultation and is completely painless, to diagnose the level of obstruction and the most appropriate treatment in each case. There are mainly two levels of tear path involvement: high and low obstructions.


High obstructions affect the onset of the tear duct, i.e. the tear duct or canalicle. The patient notices tears in the affected eye and may be the cause of infection (canaliculitis) or a tearing of the tear point. The treatment in case of canaliculitis is carried out by means of antibiotic ointments and in the obstruction of the lacrimal point it is surgery of puntoplastia.

Patient with tear duct infection at the level of the lower canalicle or canaliculitis, characterized by itching, redness, tearing and discharge of purulent material through the tear point.
Detail of the same patient where redness and pus are seen on the inner side of the eye.

Low obstructions affect the lacrimal bag, especially in its area of connection with the nasal cavity, the Hasner valve. The patient has tearing or tear bag infections or dacryocystitis . The treatment is with surgery and this can be externally or with laser. Externally, a small incision is made taking advantage of the area of the edge so that the scar is practically imperceptible. In the laser technique it is performed through the canalicles. Both techniques aim to reconnect the tear duct with its drainage to the nasal cavity so that it works again.

Detail of the area where the incision is made for external dacryocystorrinostomy surgery, so that the scar is concealed with the edge.


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