ORBIT AND OCULOPLASTY Punctoplasty:

Punctoplasty is a surgical treatment used to restore adequate tear drainage when the lacrimal punctum (puncta lacrimalia) in one or both eyes gets clogged. If there is a blockage in the puncta, physicians may recommend a punctoplasty treatment to expand the drain aperture.

A punctoplasty, also known as watery eye surgery, is an ocular surgical treatment that widens the punctal aperture to enable tears to drain more easily. It is used to treat punctal stenosis (a disease that causes tears to overflow from the eyes) by extending the punctal orifice.

Watery eyes are caused by either excessive tear production or a narrowed or obstructed drainage system in the eye.

A punctoplasty is good for all individuals who have watery eyes, which is a condition in which a person's tears overflow from their eyes, a symptom known as epiphora. It is therefore beneficial to patients who suffer from punctal stenosis, a disease in which the puncta, or little openings in the eyelids that allow tears to flow, are excessively thin or closed. Chronic inflammation of the eyelids (blepharitis) and the use of topical hypertension medicines can both induce this illness, which is more frequent in the elderly.

A punctoplasty is also beneficial for patients whose lacrimal glands generate excessive amounts of tears, which can be caused by a variety of circumstances, including eye discomfort or dryness, which drives the glands to compensate by creating more tears than necessary. This is why artificial tears are used to treat some people with watery eyes. Excess tear production is avoided by first addressing the dryness of the eyes. Watery eye surgery has a high success rate of 86 percent to 96 percent, according to records.

Disease Overview:

Punctal stenosis

Acquired punctal stenosis is a narrowing or occlusion of the external entrance of the lacrimal canaliculus, which is located in the nasal section of the palpebral border. Punctal agenesis is defined as a complete congenital blockage of the external punctum.

Disease Signs and Symptoms:

Epiphora, a rise in tear production, a constriction of the punctum, and the difficulty to insert a probe or cannula without dilatation are all symptoms. "Tissue sign" — the patient is carrying a handful of tissues into the clinic.

Disease Causes:

A common cause of acquired punctal stenosis is persistent lid inflammation, particularly chronic blepharitis. Chronic inflammation of the external punctum leads to gradual fibrotic alterations in the ostium, followed by progressive duct obstruction, according to the pathophysiology proposed.

Disease Diagnosis:

In the absence of distal tear drainage problems, such as canalicular blockage or nasolacrimal duct obstruction, punctal stenosis is clinically characterised as a punctum calibre inhibiting tear drainage.

Disease Treatment:

Long-term use of timolol, latanoprost, betaxolol, dipivefrin hydrochloride, echothiophate iodide, and pilocarpine, as well as other topical antiglaucoma drugs, has been linked to punctal stenosis. Other topical medications have also been postulated as possible causes, and are frequently used in conjunction.