Oculoplastics basic exam: Lacrimal system examination скачать в хорошем качестве

Oculoplastics basic exam: Lacrimal system examination

Evaluation of the lacrimal outflow system consist of three parts: examination of the position and the caliber of the punctum, examination of the patency of the canaliculi, and examination of the patency of the nasolacrimal duct. This can all be performed fairly easily in the clinic, but can be difficult (if not impossible) in children and some adults. Equipment needed includes a punctal dilator (I like these to have a fine point), a Bowman probe (I prefer a 0 Bowman probe), and a cannula on a 3 mL syringe (I prefer a 3 mL syringe because I get better "feel" with this size). For a written transcript of this video, please see below: 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. Over 300 oculoplastic surgery videos are available, free of charge, at http://www.oculosurg.com