NLD Syringing and probing
Probing for NLD Syringing and probing:
• only performed if the puncta are patent.
• Anaesthetic
• Instil adequate topical anaesthesia.
• Punctal dilation by a blunt dilator gently to enlarge the puncta.
• The lower lid should be pulled laterally to straighten the canaliculus prior to probing.
• Use a punctal wire probe which can be smeared with chloramphenicol ointment for lubrication.
• An attempt is made to carefully advance the probe via the lower punctum until a ‘stop’ is felt.
• It is important to feel whether the cannula is resisted by something hard (hard stop) or soft (soft stop).
• Hard stop: this occurs if the cannula enters the lacrimal sac and can be advanced up against the medial wall of the sac which lies against the lacrimal bone. This suggests patency of the proximal portion of the nasolacrimal system.
• Soft stop: this occurs if the cannula stops at or proximal to the junction of the common canaliculus and the lacrimal sac. This suggests that there is an obstruction of one of the canaliculi or at the opening of the common canaliculus into the lacrimal sac (internal opening).
Irrigation ( syringing) in NLD Syringing and probing
• performed via the lower or upper punctum with a curved, blunt-tipped lacrimal cannula on a 2.5ml syringe filled with saline.
• The tip of the cannula is gently advanced a few millimetres.
• Again remember to pull the lid laterally. Saline is gently irrigated. If saline flows freely into the nose then the nasolacrimal drainage system is patent.
• If there is regurgitation through the opposite punctum then common canalicular obstruction is likely.
• If there is regurgitation through the ipilateral punctum then ipsilateral canalicular obstruction is likely.
• If mucus or fluorescein regurgitates, then there is likely to be a dilated lacrimal sac or mucocele.
NLD Syringing and probing Videos :
Nasolacrimal Duct Obstruction ( NLD Syringing and probing ) – YouTube
NLD Syringing and probing power point presentations:
Tests done to assess patency of lacrimal drainage ( NLD Syringing and probing )
Evaluation of nasolacrimal system by Balasubramanian Thiagarajan ( NLD Syringing and probing )
Lacrimal sac syringing ( NLD Syringing and probing )
Lacrimal Apparatus It is physiological system has formation and drainage also give nurshiment to cornea with help of tear HENCE Any occlusion or defect in lacrimal drainage detected to a investigation is called lacrimal syringing. Syringing is the method to test the structural integrity of lacrimal drainage system .
NLD Syringing and probing