68530 Removal of foreign body or dacryolith, lacrimal passages

Name of the Procedure:

Removal of Foreign Body or Dacryolith, Lacrimal Passages

• Common Name: Lacrimal Duct Debridement
• Medical Term: Dacryolith Removal

Summary

In this procedure, a doctor removes debris or stones from the tear ducts, which are small channels that carry tears from the eyes into the nasal cavity. This can help restore proper tear drainage and alleviate discomfort.

Purpose

This procedure addresses blockages in the tear ducts caused by foreign objects or dacryoliths (stone-like formations).

• Goals: Restore normal tear drainage, relieve discomfort, and prevent recurrent infections.

Indications

• Persistent tearing (epiphora)
• Recurrent eye infections or dacryocystitis
• Pain or swelling near the inner corner of the eye
• Discharge from the eye
• Diagnosis of a blockage in the lacrimal passages via imaging or probing

Preparation

• Pre-procedure Instructions: Follow doctor's recommendations regarding fasting (usually not required); adjust medications as advised.
• Diagnostic Tests: Possible imaging (e.g., dacryocystography) or probing of the tear ducts.

Procedure Description

1. Anesthesia: Local anesthesia to numb the area around the eye.
2. Step-by-Step:
   • The doctor gently dilates the opening of the tear duct.
   • Specialized instruments are used to remove the foreign body or dacryolith.
   • The area may be flushed with a saline solution to ensure all debris is cleared.
3. Tools: Fine probes, forceps, flushing apparatus.

Duration

Typically, the procedure takes about 30 minutes to 1 hour.

Setting

Usually performed in an outpatient clinic or an ophthalmologist’s office.

Personnel

• Ophthalmologist or Oculoplastic Surgeon
• Nurse or medical assistant

Risks and Complications

• Common Risks: Temporary discomfort, minor bleeding, swelling.
• Rare Complications: Infection, scarring, damage to the tear duct, recurrence of blockage.

Benefits

• Expected Benefits: Relief from excessive tearing, reduced risk of infections, improved comfort.
• Timeline: Most patients notice an improvement within a few days to a week.

Recovery

• Post-Procedure Care: Use prescribed antibiotic eye drops or ointments; avoid rubbing the eyes; follow specific hygiene instructions.
• Recovery Time: Usually a few days; avoid strenuous activities for 1-2 days.
• Follow-Up: A follow-up visit might be scheduled within a week to ensure proper healing.

Alternatives

• Conservative Management: Warm compresses, massage, and antibiotics for infections.
• Surgical Options: Dacryocystorhinostomy (DCR) for more severe or recurrent blockages.
• Pros and Cons: Alternatives may be less invasive but might not be as immediately effective for significant obstructions.

Patient Experience

• During the Procedure: Mild discomfort or pressure; local anesthesia will minimize pain.
• After the Procedure: Some soreness and swelling are normal; pain medication may be prescribed if necessary.
• Pain Management: Over-the-counter pain relief or prescribed medications as needed.