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Jean Edwards Holt, MD; G. Richard Holt, MD

Arch Otolaryngol. 1984;110(4):211-220.

Abstract
• The lacrimal drainage system is both an anatomic and a physiologic system. Anatomic abnormalities may be a result of congenital defects, infection, trauma, or tumors. The physiologic action of the eyelids, if altered, will affect the tear flow as well as disturb the lacrimal pump. Physiologic and anatomic abnormalities may be defined using the Schirmer, basic secretion, Jones I and II dye, and fluorescein dye disappearance tests. Once the correct diagnosis has been made, the appropriate surgical procedures restore the system's integrity. Punctal abnormalities and eyelid malpositions require surgical correction. Canalicular lacerations should be primarily repaired. Lacrimal sac obstruction is treated with a dacryocystorhinostomy and canalicular intubation. Placement of a Jones tube is required for obstruction of the upper collecting system.

(Arch Otolaryngol 1984;110:211-220)

Author Affiliations
From the Department of Ophthalmology (Dr J. Holt) and the Division of Otorhinolaryngology (Dr R. Holt), University of Texas Health Science Center, San Antonio.

Footnotes
Accepted for publication Sept 22, 1983.

Read in part before the southern section meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Durham, NC, Jan 12, 1983, and the fourth international symposium on Facial Plastic and Reconstructive Surgery, Los Angeles, May 30, 1983.

Reprint requests to Department of Ophthalmology, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284 (Dr J. Holt).

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