Page 1 of 1: Ophthalmology : Nasolacrimal Duct Probing

rsvv79 · Credits: 5424 My Scrapbook

During probing in a case of dacryocystitis a SOFT stop will occur in

1. Common canalicular block
2. Nasolacrimal duct block
3. Punctual block(or is it punctal block)
4. None of the above

The ans given is 1.No idea about this one.Can somebody please explain the expected findings while probing a nasolacrimal duct in various conditions??

parin · Credits: 14680 My Scrapbook My Reading List 1 Books

Soft stop: It is a spongy feeling as the lacrimal canula presses the common canaliculus & the lateral wall against the medial wall of the sac. This indicates that the cannula has been prevented from entering the lacrimal sac by an obstruction in the canalicular system. Irrigation will therefore not cause the sac to distend. In case of loewr canalicular obstruction there will be reflux of saline through the lower canaliculus. Reflux through the upper canaliculus indicates patency of both the upper & the lower canalicule, but a total obstruction of the common canaliculus..

Hard stop: It is a firm feeling by the cannula touching the medial wall of the lacrimal sac & the lacrimal bone. This usually indicates that the lacrimal sac has been entered & excludes the complete obstruction to the canalicular system. The examiner then places one finger over the lacrimal fossa & starts to irrigate. If the saline passes into the nose the patient may have no obstruction (& the cause of watering is either hypersecretion or failure of the lacrimal pump system), or he may have a partial obstruction..

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