68840 Probing of lacrimal canaliculi, with or without irrigation

Name of the Procedure:

Probing of Lacrimal Canaliculi (Commonly referred to as "Lacrimal Duct Probing")

Summary

Probing of lacrimal canaliculi is a procedure to open up blocked tear ducts. By using a fine instrument, medical professionals can clear or widen the tear ducts to allow tears to drain properly, which can relieve symptoms such as excessive tearing or recurrent eye infections.

Purpose

This procedure addresses blockages or narrowing in the tear drainage system. The expected outcome is the restoration of normal tear drainage, reducing symptoms of excessive tearing (epiphora) and preventing recurrent eye infections.

Indications

• Persistent excessive tearing (epiphora)
• Recurrent eye infections (dacryocystitis)
• Congenital nasolacrimal duct obstruction in infants and young children
• Swelling and redness around the inner corner of the eye

Preparation

• Patients may need to undergo a comprehensive eye examination.
• Pre-procedure assessments might include tear duct irrigation and imaging studies.
• Generally, no fasting is required, but patients need to inform their doctor about any medications they are taking.

Procedure Description

1. The area around the eye is cleaned and sterilized.
2. Topical anesthesia drops are applied to numb the eye area.
3. A thin, blunt probe is gently inserted into the punctum (opening of the tear duct) and advanced through the canaliculi to clear any blockages.
4. Irrigation with a saline solution may be used to ensure the ducts are open and functioning.
5. If necessary, the procedure can be repeated to ensure complete patency of the duct.
6. The process is quick and usually completed within a few minutes.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

Probing of lacrimal canaliculi is usually performed in an outpatient clinic or an ophthalmologist's office.

Personnel

• An ophthalmologist or a trained eye specialist performs the procedure.
• A nurse or medical assistant may be present to assist.

Risks and Complications

• Mild discomfort or irritation
• Temporary swelling or redness
• Rarely, minor bleeding or infection
• Scar tissue formation or duct damage (very rare)
• Allergic reactions to anesthesia (extremely rare)

Benefits

• Relief from excessive tearing and associated discomfort
• Reduction in recurrent eye infections
• Improvement in overall eye health and comfort
• Results can often be seen almost immediately.

Recovery

• Patients may experience mild discomfort or irritation, which usually resolves within a day.
• Use antibiotic eye drops as prescribed to prevent infection.
• Avoid touching or rubbing the eyes.
• Follow up with the ophthalmologist as recommended.

Alternatives

• Conservative management with warm compresses and massage.
• Balloon dacryoplasty.
• Surgical procedures like dacryocystorhinostomy (DCR) if probing is unsuccessful.
• Each alternative has its own risks and benefits which should be discussed with a healthcare provider.

Patient Experience

• Minimal discomfort during the procedure due to local anesthesia.
• Some pressure sensation as the probe is inserted.
• Post-procedure, slight irritation or tearing may occur but usually resolves quickly.
• Pain relief and comfort measures include over-the-counter pain medications if needed.