Examination of the Eyelids and Nasolacrimal Duct

The upper eyelid covers the superior margin of the cornea. A few millimeters of the sclera will be visible above the lower eyelid. The eyelids are in direct contact with the eyeball.

Stenosis of the nasolacrimal duct produces a pool of tears in the medial angle of the eye with lacrimation (epiphora). In inflammation of the lacrimal sac, pressure on the nasolacrimal sac frequently causes a reflux of mucus or pus from the inferior punctum. Patency of the nasolacrimal duct is tested by instilling a 10% fluorescein solution in the conjunctival sac of the eye. If the dye is present in nasal mucus expelled into paper tissue after two minutes, the lacrimal duct is open (see also p. 53).

H Due to the danger of infection, any probing or irrigation of the nasolacrimal duct should be performed only by an ophthalmologist.

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