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Punctal and Canalicular Stenosis or Blockage


People that offer with tearing (labeled epiphora) should go through a complete sensory and also oculoplastic exam.

Tearing can be caused by several conditions like the following:

  • Overproduction of tears
  • Nasolacrimal duct obstruction
  • Punctal constriction featuring or without canalicular stenosis
  • Dry eyes
  • Conjunctivitis
  • Allergies

Punctal stenosis leads to a narrow opening of the tear duct system, when this happens it is described as the puncta. In specific situations the opening of the tear duct can become narrowed (stenotic), when this happens the tears that typically drain down into the puncta and the other parts of the tear ductwork system don’t drain correctly. Punctal stenosis can typically exist along with canalicular stenosis. The two conditions together can make a patient’s life very uncomfortable. The canaliculi are sectors within the tear duct system that link the puncta and the lacrimal pouch as well as remaining nasolacrimal duct.

The causes vary and differ of punctal and/or canalicular stenosis, a few of that include:

  • Chronic conjunvitis (sensitive or infectious)
  • Medication related
  • Topical eye (sensory) drugs
  • Wide spread drugs consisting of particular chemotherapy drugs such as Taxotere as well as 5-fluorouracil (5-FU).
  • Blepharitis
  • Trauma
  • Eyelid malpositions (such as entropions and also ectropions)
  • Uncertain etiology
  • Eyelid neoplasms (benign or deadly)

To manage the condition, diagnosis of punctal with or without canalicular constriction must first be made. Also identification of the etiology (or reason) must be addressed as well. In specific cases where the source is recognized. everything needs to be done to avoid it and it must be treated (Like in cases of blepharitis or hypersensitive conjunctivitis). If stenosis is only found around the puncta, a close administration featuring topical drugs can commonly help in enhancing the stenosis. Nevertheless, clients could require a somewhat minor treatment to expand the stenotic puncta described as a punctoplasty treatment. This procedure is oftentimes performed directly in the office under a local and mild anesthesia as well as individuals allow it effectively.

When Dr. Morris determines the puncta and also canalicular system are stenotic as well as traditional therapy has not boosted the circumstances, timely attachment of ecologically safe silicone tubes must be put within the puncta and also canalicular system to help protect against continuous and/or worsening stenosis. If the reason could not be stayed clear of (like those specific clients undergoing chemotherapy), prompt installation of the silicone tubes during the course period of the radiation treatment routine is essential for the patient to avoid full blockage.

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