Injuries to the Lacrimal System

 Injuries to the Lacrimal System

Etiology:

Lacerations and tears in the medial canthus (such as dog bites orglass splinters) can divide the lacrimal duct. Obliteration of the punctum and lacrimal canaliculus is usually the result of a burn or chemical injury. Injuryto the lacrimal sac or lacrimal gland usually occurs in conjunction with severe craniofacial trauma (such as a kick from a horse or a traffic accident). Dacryocystitis is a common sequela, which often can only be treated by surgery (dacryocystorhinostomy).

Clinical picture:

See Fig. 18.3 for avulsion ofthe lower lacrimal system (avulsions in the medial canthus).

Treatment:

Lacrimal system injuries are repaired under an operating micro-scope. A ring-shaped silicone stent is advanced into the canaliculus using a special sound (Figs. 18.3b – f). The silicone stent remains in situ for three to four months and is then removed.

Surgical repair of eyelid and lacrimal system injuries must be performed by an ophthalmologist.


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