Our tears are produced by several glands surrounding the eyes. After lubricating the eye surface, tears must drain to the nose. They do so through small openings in the eyelids, called lacrimal puncti. After entering the puncti, tears travel to the nasal cavity and then to the throat. This process explains why we can taste drops applied in the eyes.
The lacrimal puncti may become smaller with age, impeding the passage of tears down to the nose. This is called punctal stenosis. Clinically, stenosis of the puncti causes constant tearing in one or both eyes, especially when exposed to air conditioning or when reading for prolonged periods. In this scenario, the eyelid surgeon has at his disposal a procedure that can help to restore tear flow. This procedure is called punctoplasty.
Punctoplasty: a quick procedure to fix lacrimal obstruction
When a patient’s tearing is due to punctal stenosis, punctoplasty can improve their complaints significantly. It is a 5-minute operation done under local anesthesia in the doctor’s office or a minor procedure room. The area adjacent to the lacrimal punctum is anesthetized initially. Then, the lacrimal punctum is dilated with a surgical probe; and finally, microsurgical scissors are utilized to expand the opening of the punctum (see video).
The operation is quick, safe, and painless. The patient is instructed to apply antibiotic drops in the operated eye three times a day for one week. Once the opening has been made, tears can flow easily, and patients experience improvement of unwanted tearing.
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