The Ductus nasolacrimalis, also known as the nasolacrimal duct, is a narrow tube that drains tears from the eye into the nose. It starts at the inner corner of the eye and extends downward into the nasal cavity, where it opens into the lower part of the nasal passage.
The nasolacrimal duct plays an important role in maintaining the moisture and health of the eye. Tears produced by the lacrimal gland in the upper outer corner of the eye flow across the surface of the eye and drain into small openings called puncta located at the inner corners of the upper and lower eyelids. From there, the tears flow through small channels called canaliculi and into the nasolacrimal duct, which carries them into the nose.
Problems with the nasolacrimal duct can cause a variety of symptoms, including excessive tearing, eye redness, and recurrent eye infections. In some cases, a blockage in the nasolacrimal duct may require treatment, such as flushing the duct with saline solution or inserting a small tube called a stent to keep the duct open. In rare cases, surgery may be needed to repair a blockage or other problem with the nasolacrimal duct.
There are several operations that can be performed on the tear ducts to treat problems such as blockages or narrowing of the tear ducts. Some of the most popular operations on the tear ducts include:
- Dacryocystorhinostomy (DCR): This is a surgical procedure that creates a new drainage channel between the tear sac and the nose, bypassing any blockages in the nasolacrimal duct. It may be performed using a traditional “external” approach or a newer “endoscopic” approach that uses smaller incisions and a camera to guide the surgeon.
- Balloon dacryoplasty: This is a minimally invasive procedure that uses a small balloon to widen a narrow tear duct. The balloon is inserted into the tear duct and inflated to open up the passage, and then removed.
- Jones tube placement: This procedure involves placing a small plastic or glass tube between the tear sac and the nose to help drain tears. The tube is typically left in place permanently.
- Lester Jones tube placement: Similar to Jones tube placement, this procedure involves inserting a longer tube into the tear duct system. This tube is usually placed in patients who have more extensive blockages or previous surgeries that have failed.
- Placement of punctum plugs © –
- Placement of punctal plugs, also known as lacrimal plugs or punctum plugs, is a procedure to help treat dry eye syndrome. The puncta are small openings located on the inner corner of the upper and lower eyelids that drain tears from the eye into the nasolacrimal duct. Punctal plugs are small devices that are inserted into these openings to block the tear drainage channels, thus increasing the amount of tears that stay on the surface of the eye.
- The procedure for punctal plug insertion is simple and usually done in the eye doctor’s office. The patient’s eye is numbed with a local anesthetic eye drop, and then the punctum plug is inserted into the puncta using a special tool. The plug can be made of silicone, collagen, or other materials, and can be either temporary or permanent.
- Temporary punctal plugs are typically made of dissolvable materials and will gradually dissolve over a period of weeks to months. Permanent punctal plugs can remain in place indefinitely, but can also be easily removed if necessary.
- Punctal plugs can be an effective treatment for people with dry eye syndrome, particularly those who have not found relief from other treatments such as artificial tears or prescription eye drops. However, like all medical procedures, there are risks and potential side effects associated with punctal plug insertion, including infection, irritation, and dislodgement of the plug. It is important to discuss the risks and benefits of punctal plugs with an eye doctor before undergoing the procedure.
- The silicone tube intubation –
- Silicone tube intubation is a surgical procedure used to treat problems with tear drainage, such as nasolacrimal duct obstruction or other forms of epiphora (excessive tearing). During the procedure, a small silicone tube is inserted into the tear duct system to help keep it open and promote drainage of tears from the eye.
- The procedure is typically performed under local anesthesia and may be done on an outpatient basis. The surgeon will make a small incision near the inner corner of the eye and insert the silicone tube into the puncta, which are small openings in the tear drainage system located at the inner corner of the upper and lower eyelids. The tube is then passed through the canaliculi, the small channels that connect the puncta to the tear sac, and into the nasolacrimal duct.
- The silicone tube is usually left in place for several months to help promote proper drainage of tears. After this time, the tube is typically removed in a simple office procedure. In some cases, the tube may need to be left in place permanently to maintain proper tear drainage.
- Silicone tube intubation can be an effective treatment option for people with tear drainage problems who have not responded to other treatments such as punctal plugs or medication. However, like all surgical procedures, there are risks associated with silicone tube intubation, including infection, scarring, and dislodgement of the tube. It is important to discuss the risks and benefits of the procedure with an eye doctor before undergoing the surgery.
These procedures can help to relieve symptoms such as excessive tearing, eye irritation, and recurrent infections by restoring proper drainage of tears from the eye. The specific procedure recommended will depend on the individual’s unique needs and the underlying cause of their tear duct problem.