Clinical Evaluation and Imaging of Lacrimal System Obstruction



The lacrimal drainage apparatus is an intricate mucous membrane-lined conduit the function of which depends on a complex interplay of anatomy and physiology. Appropriate drainage of tears depends on several factors, including the volume of tear production, eyelid position, normal pump mechanisms, anatomic status of the drainage passages, gravity, and nasal air convection currents. The patient with symptomatic epiphora may have a normal anatomic system overwhelmed by an oversecretion syndrome, or a drainage system that is anatomically compromised and is therefore unable to handle normal tear production. Conversely, patients may have partial or complete blockage of the nasolacrimal system but experience no symptoms or have symptoms of dry eye if tear production is significantly reduced. The clinical picture of bothersome epiphora thus depends on the balance of tear production and tear drainage, not on the absolute function of either one.


Nasolacrimal Duct Schirmer Test Nasolacrimal Duct Obstruction Physiological Dysfunction Lacrimal System 
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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of OphthalmologyUniversity of North CarolinaChapel HillUSA
  2. 2.Department of OphthalmologyMoore Regional Hospital, Carolina Eye AssociatesSouthern PinesUSA

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