Lacrimal flow defects

After verifying the level of lacrimal drainage deficit through the survey of the lacrimal pathways (Schirmer survey), the most appropriate treatment is selected. In some cases, it is advisable to perform a dacryo-CT with contrast medium, which allows to see the entire pathway of the tear ducts.

In case of congenital stenosis (closure) of the lacrimal ducts, the child will be positioned, under light general anesthesia, a canalicular prosthesis that must be maintained for about 3 months. This small prosthesis will determine a dilation of the entire pathway of the tear ducts. In case of acquired stenosis (generally secondary to major conjunctivitis), the intervention of choice is the external dacryocystorhinostomy and can be performed under general anesthesia or local anesthesia with sedation. Through a mini-incision is made the removal of a small portion of bone at the base of the nasal wall (no deformities remain), then proceeding to the reconstruction of the tear flow and placing a prosthesis canalicular through the tear ducts that for about a month will be maintained in place.

The patient has a bandage with the eye covered for about 3-4 hours, instead the sutures will be removed after 5-6 days. The patient will have to take antibiotic therapy in tablets for 7-14 days. Normally, no discomfort is reported in maintaining the canalicular prosthesis and the benefit of the disappearance of hyperlacrimation is noted immediately. For congenital stenosis the maintenance of the canalicular prosthesis is generally about 3 months, while for acquired forms it is about 1-3 months, depending on the possible recurrence of occlusion of the lacrimal pathways; the removal of the canalicular prosthesis does not involve pain to the patient and is performed on an outpatient basis.