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Tears are produced by the lacrimal gland, situated just outside the eye. Blinking the eyelids distributes the tears to keep the eyes moist, clean and lubricated. Excess tears are drained via the punctum through the tiny channels called canaliculi located on the inner side of the eyes into the tear sac, from there to the tear duct, the nose and finally down the throat.
A punctal plug, also known as tear duct plug or lacrimal plug, is a small medical device that is inserted into the tear duct (puncta) of an eye to block the duct. This prevents the drainage of liquid from the eye. They are used to treat dry eye. Artificial tears are usually still required after punctal plug insertion. [1]
Around 6% of infants have congenital nasolacrimal duct obstruction, or dacryostenosis, usually experiencing a persistent watery eye even when not crying. If a secondary infection occurs (dacryocystitis), purulent (yellow / green) discharge may be present. Most cases resolve spontaneously, with antibiotics reserved only if conjunctivitis occurs.
Dry eye syndrome, also known as keratoconjunctivitis sicca, is the condition of having dry eyes. [2] Symptoms include dryness in the eye, irritation, redness, discharge, blurred vision, and easily fatigued eyes. Symptoms range from mild and occasional to severe and continuous. [3]
A punctal plug may be inserted into the tear duct by an optometrist or ophthalmologist, decreasing the removal of natural tears from the affected eye. [ 8 ] The use of contact lenses may help prevent the abrasion during blinking lifting off the surface layer and uses thin lenses that are gas permeable to minimise reduced oxygenation.
Mild conjunctivochalasis can be asymptomatic and in such cases does not require treatment. Lubricating eye drops may be tried but are often ineffective. [8] If discomfort persists after standard dry eye treatment and anti-inflammatory therapy, surgery may be undertaken to remove the conjunctival folds and restore a smooth tear film.
The CDC warned that EzriCare Artificial Tears eyedrops may be linked to a drug-resistant bacterial infection that has caused permanent vision loss and one death.
use of a specially designed eyelid occlusion dressing; use of eye ointment (although this is controversial, see below) bio-occlusive dressings; suture tarsorrhaphy; However, none of the protective strategies are completely effective; vigilance is always required i.e. the eyes need to be inspected regularly throughout surgery to check they are ...