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Data and Picture Interpretation Stations: Cases 1–45
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Other causes include dacryocystitis or nasolacrimal duct obstruction. The nasolacrimal duct may be obstructed by blockage or strictures: dacryolithiasis, chronic rhinosinusitis, previous FESS, naso-orbito-ethmoidal fractures, neoplasms, periorbital radiotherapy, some chemotherapy agents or inflammatory disease (e.g. sarcoidosis or granulomatosis with polyangiitis).
Central nervous system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The lacrimal system comprises the lacrimal gland, which secretes tears, the lacrimal sac and the ducts through which the tears pass into the nasal cavity (Figs 11.59a–c). The lacrimal gland lies anteriorly in the upper outer quadrant of the orbit and communicates with the lacrimal sac via the lacrimal canaliculi. Tears wash over the surface of the eye and drain through the lacrimal canaliculi into the lacrimal sac through two openings, the puncta lacrimalia, which are situated on the medial aspects of the upper and lower eyelids. The lacrimal sac drains into the nasolacrimal duct, which runs vertically through the lateral nasal wall on the medial aspect of the maxillary antrum. The nasolacrimal duct opens into the nasal cavity below the inferior nasal conchus.
Watery Eyes
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Differential diagnoses of a watery eye can be classified into three main categories: Hyperlacrimation: The overproduction of normal tears may occur secondary to ocular surface disease and conjunctivitis. The overproduction of poor quality tears, sometimes confusingly termed ‘dry eyes’ can be caused by anything from drugs and radiotherapy to autoimmune diseases such as Sjögren's syndrome or meibomian gland dysfunction. It often confuses patients in this situation that an ocular lubricant can actually help with their watery eyes.Eyelid malposition: If a regular amount of normal quality tears are produced this can still lead to watering if the eyelid impedes its flow through to the puncta. This can be due to ectropion, entropion, lagophthalmos and any punctual abnormalities.Nasolacrimal duct obstruction: This may occur at any point from the punctum to the nose (see Figure 3.1) due to infection, inflammation, compression or infiltration.
In vivo analysis of endocanalicular light pipe transillumination in endoscopic dacryocystorhinostomy: Anatomic considerations and cautions for the transitioning
Published in Orbit, 2022
Nina S. Boal, Elizabeth A.Z. Cretara, Benjamin S. Bleier, Allen C. Lam, Daniel R. Lefebvre
This study was approved by the Institutional Review Board (IRB) of Massachusetts Eye and Ear and was HIPAA-compliant with the protection of individually identifiable health information, and was conducted in accordance with the Declaration of Helsinki. The charts of 32 patients who underwent endo-DCR and included lacrimal sac transillumination performed by the authors at Massachusetts Eye and Ear from April 2015 through October 2016 were reviewed. All patients had a diagnosis of primary acquired nasolacrimal duct obstruction. Patients with a prior history of lacrimal surgery or trauma to the lacrimal sac area were excluded. Operative notes were reviewed and the location of transillumination in relation to the maxillary line had been noted. CT scans had been obtained only for patients with chronic rhino-sinusitis in whom concurrent image-guided endoscopic sinus surgery was planned.
Eye Make-up Products and Dry Eye Disease: A Mini Review
Published in Current Eye Research, 2022
Mazyar Yazdani, Katja Benedikte Prestø Elgstøen, Tor Paaske Utheim
Tear fluid and particles attached to the ocular surface are drained by the nasolacrimal duct into the inferior meatus of the nose. Anatomically, the lacrimal passages are divided into bony and membranous lacrimal sections. The latter include the lacrimal canaliculi, lacrimal sac, and the nasolacrimal duct. The last two parts are lined by a double-layered epithelium containing superficial columnar cells and basal flattened cells. Goblet cells may also be present in the epithelial layer. During blinking, tears are wiped and pushed into the lacrimal puncta, small openings located in the nasal upper and lower eyelids. The punctum ends in the canaliculus, where the fluid drains into the lacrimal sac followed by the nasolacrimal duct canal before reaching the nasal cavity.31
Punctal stenosis associated with dupilumab therapy for atopic dermatitis
Published in Journal of Dermatological Treatment, 2021
Debora H. Lee, Liza M. Cohen, Michael K. Yoon, Jeremiah P. Tao
Systemic drugs can affect different compartments of the eye and in turn produce a variety of ocular side effects. While drug-induced conjunctivitis may present with redness and irritation for example, retinal toxicity can result in visual loss (10). Certain drugs (e.g. docetaxel) also cause narrowing or obstruction of the lacrimal drainage system which can in turn lead to epiphora (11). The development of symptoms and strategies for management will depend on the site and extent of the drainage occlusion. Normally, tears from the ocular surface drain through the puncta (upper and lower), canaliculi, lacrimal sac, and then out the nasolacrimal duct. If there is suspicion for occlusion, diagnostics tests such as the dye disappearance test and Jones tests can be used to evaluate the flow of fluorescein dye through the lacrimal drainage system. Depending on the level of drainage occlusion, treatments to facilitate tear drainage may include punctal dilation, snip punctoplasty, or intubation with lacrimal stents. Of course, if the occlusion is drug-induced, cessation of the medication could also be a consideration.