Name of the Procedure:

Probing of nasolacrimal duct, with or without irrigation
Common name: Tear duct probing

Summary

Probing of the nasolacrimal duct is a procedure used to clear blockages in the tear drainage system, typically in infants or young children. A small, thin probe is inserted through the tear duct to open any obstructions, sometimes combined with irrigation to flush out any debris.

Purpose

This procedure addresses nasolacrimal duct obstruction, which prevents tears from draining properly from the eyes into the nasal cavity.

• Goals: Ensure proper tear drainage, alleviate symptoms like excessive tearing, discharge, or recurrent eye infections.

Indications

• Persistent excessive tearing (epiphora)
• Recurrent eye infections or inflammation (dacryocystitis)
• Tear duct blockage confirmed through diagnostic tests
• Usually indicated for infants and young children under 1 year of age

Preparation

• No significant preparation required for infants
• Patients (or their guardians) should follow specific instructions provided by the healthcare provider
• Pre-procedural examination to confirm blockage

Procedure Description

1. The patient is usually given a mild sedative to minimize discomfort and movement.
2. Local anesthesia may be administered around the eye to numb the area.
3. A thin metal probe is gently inserted through the tear duct opening in the eyelid.
4. The probe is advanced through the duct until it reaches the nasal cavity, clearing any obstructions.
5. Irrigation with a saline solution may be used to flush out any debris.
6. The probe is then removed.

Duration

The procedure typically takes about 10 to 20 minutes.

Setting

• Outpatient clinic
• Hospital setting (usually outpatient surgery center)

Personnel

• Ophthalmologist (usually a pediatric ophthalmologist)
• Nurse or medical assistant

Risks and Complications

• Common risks: Minor bleeding, temporary discomfort
• Rare complications: Infection, damage to the tear duct, recurrence of blockage

Benefits

• Expected benefits: Relief from symptoms of tearing and infection, improved tear drainage
• Benefit realization: Immediate to within a few days

Recovery

• Minimal aftercare needed
• Avoid touching or rubbing the area around the eyes
• Follow-up appointment to monitor progress
• Eye drops may be prescribed to prevent infection

Alternatives

• Non-surgical: Massage of the nasolacrimal sac (Crigler massage), particularly in infants
• Surgical: Dacryocystorhinostomy (DCR) if probing is unsuccessful and the blockage is severe

Patient Experience

• During the procedure: Patients (infants/children) are usually sedated and feel minimal discomfort
• After the procedure: Slight tenderness around the eyes, generally mild
• Pain management: Over-the-counter pain relief if necessary
• Comfort measures: Parental soothing and follow-up care instructions provided by the healthcare team