Risk Management

Probing and Irrigation of Tear Duct (Nasolacrimal System) of Adult Patient

Please click on this link to download a copy of the probing and irrigation of tear duct of adult patient consent form.

Probing and Irrigation of Tear Duct (Nasolacrimal System) of Adult Patient

What is the nasolacrimal system?

The tears are produced by the lacrimal gland located in the eye socket in the upper outer corner on both sides.  The tears go onto the eyeball and drain down the nose and throat through the nasolacrimal duct drainage (tear drain) system.

What is a tear duct obstruction?

A tear duct (tear drain) obstruction occurs when one of the areas of the drainage system is blocked. In children, this occurs when a membrane blocks the drain where it enters the nose. In adults, it can be anywhere in the system. Tears cannot drain if the tear drain is not open. A blocked tear duct system can become infected and cause “pink eye” (conjunctivitis). The infection can become more serious and cause swelling of the eyelid and tissue around the eye (cellulitis).

What is the goal of probing and irrigation?

The ophthalmologist (eye surgeon) probes and irrigates the tear drain to find where the blockage is and see how much it is blocked.

How is probing and irrigation performed?

The ophthalmologist uses anesthesia eye drops to lessen the discomfort. The ophthalmologist next widens the opening called   the puncta (the two little holes in the eyelid) with a tiny metal tool. Then the ophthalmologist puts a thin metal tool through the drain) until it reaches the inner nose.

The ophthalmologist next slowly injects sterile salt solution through the drain to make sure it is open and there is no blockage.

What are the main risks of the probing and irrigation?

 As with all surgery, there are risks (problems that can happen) with. Here are some of the most common or serious risks:

• Pain
• Swelling
• Infection
• Making the blockage  worse
• The need for a different type of surgery a later date

Consent

By signing below, you consent (agree) that:

• You read this informed consent form, or someone read it to you.
• You understand the information in this informed consent form.
• The ophthalmologist or staff answered your questions about probing and irrigation of the tear duct.
• The ophthalmologist or staff offered you a copy of this informed consent form.
• You accept that you may need another probing or another type of surgery.
• You understand that there may be additional costs if you need more surgery or other treatment.

I consent to probing and irrigation of tear ducts of the:

________ Right eye     _________ Left eye   _________ Both eyes

Patient (or person authorized to sign for patient)     Date: