Ultrasonic visualization of the effect of blinking on the lacrimal pump mechanism

Pavlidis, Mitrofanis; Stupp, Tobias; Grenzebach, Ulrike; Busse, H.; Thanos, Solon

doi:10.1007/s00417-004-1033-5

Cited by 38 publications

(28 citation statements)

References 23 publications

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“…All our five cases of unsatisfactory FDDT-10 gain (less than 65%) after surgically successful probing had an altered preprobing echographic LS score, speculatively indicating that a scarcely recoverable functional LDS blockage may be due to an abnormal lacrimal dynamic, which takes place in CNLDO patients with aberrant LS pattern. This hypothesis is also indirectly supported by previous observations, suggesting that a low compressibility of the LS could be a sign of functional insufficiency of the lacrimal pump mechanism [35,46,47]. In Fig.…”

Section: Discussionsupporting

confidence: 71%

Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography

Steindler¹,

Mantovani²,

Incorvaia

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionsupporting

confidence: 71%

Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography

Steindler¹,

Mantovani²,

Incorvaia

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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“…In recent years, the newly emerged lacrimal CT 3D reconstruction, based on the contrast agent injection (iodized oil) into LSC, could perform the tomoscan, and it could penetrate the surrounding bony substances, and display LSC, but because its premise is also based on the injection of contrast agent into LSC, so the displayed LSC is not its natural size (Limongi et al, 2012;Yu et al, 2013). the ultrasonography has the characteristics of economy, convenience, noninvasion and reproducibility (Pavlidis et al, 2005;Bojakowski et al, 2013;Beltrán et al, 2015), while the commonly used ophthalmic ultrasound (10 MHz) is a 2D ultrasound (Stupp et al, 2004;Tan et al, 2011), which could not exhibit the 3D structure of LSC, and it could also not display the situations of surrounding blood supply.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic 3D Reconstruction and Measurement of Lacrimal Sac in Normal Adult Chinese Population

et al. 2016

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TAO, H.; LIU, X.; MEI, X.; HAN, C.; WANG, P. & BAI, F. Ultrasonic 3D reconstruction and measurement of lacrimal sac in normal adult Chinese population. Int. J. Morphol., 34(4):1357Morphol., 34(4): -1361Morphol., 34(4): , 2016. SUMMARY:To apply the ultrasonic 3D reconstruction method to measure the anatomic image data of lacrimal sac in the normal adult Chinese population, providing imaging anatomical basis for the clinical diagnosis and treatment of lacrimal duct diseases. 80 volunteers without lacrimal duct diseases were enrolled. The GE Voluson E8 ultrasonic diagnostic apparatus was used, with gynecological intracavitary probe (frequency: 5 ~ 12MHz) for the examination and measurement. Each datum was repeated three times for the average value. Among the 80 eyes, the lacrimal sacs of 74 eyes exhibited the clear imaging, with the imaging rate as 92.5 %. the vertical diameter of lacrimal sac cavity (LSC): 13.3±2.2 mm; anteroposterior diameter: 6.0±1.1 mm; trans diameter: 4.9±0.9 mm; the vertical distance from the sac cavity top to the skin surface: 6.3±0.12 mm, the vertical distance from the sac cavity bottom to the skin surface: 6.5±0.11 mm; the distance from the angular artery to the medial canthus: 7.8±0.05 mm; the vertical distance from the angular artery to the skin surface: 7.7±0.08 mm. The lacrimal sac and angular artery in the adults could be shown clearly in ultrasonic 3D reconstruction, the accumulated anatomical parameters could provide the instructive meanings towards the clinical diagnosis and treatment of lacrimal diseases.

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“…4,5 This is aided by contraction, in a superior direction, of the lacrimal part of the orbicularis muscle (Horner's muscle) with blinking with completion of lid closure compressing both canaliculi and the lacrimal sac, forcing the tears through the drainage system. [6][7][8] Expansion of the lacrimal sac during the opening phase of blink causes suction and after opening of the eyelids, the punctal, canalicular and lacrimal sac vacuum breaks to reload with tear fluid. 5,8 There is also thought to be a passive wringing out of the sac because of its medial attachment and helically arranged fibrillar structures.…”

mentioning

confidence: 99%

“…[6][7][8] Expansion of the lacrimal sac during the opening phase of blink causes suction and after opening of the eyelids, the punctal, canalicular and lacrimal sac vacuum breaks to reload with tear fluid. 5,8 There is also thought to be a passive wringing out of the sac because of its medial attachment and helically arranged fibrillar structures. 3 In the above processes, the puncta are usually thought of as only minute orifices through which tears gain entry into the canalicular system.…”

mentioning

confidence: 99%

Punctal function in lacrimal drainage: the ‘pipette sign’ and functional ectropion

Beigi

Gupta

Luo

et al. 2015

Clinical and Experimental Optometry

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Background:The aim was to assess the movements of the inferior punctum during blinking and discuss pertinent clinical applications. Methods: This is a prospective, non-comparative observational case-series examining the function of inferior punctum during blinking using video recordings of the blinking action at the slitlamp with slow-motion analysis and comparison. Results: In all 56 eyes of 28 patents, supero-medial movement of the lower punctum toward the medial canthus, together with a medially directed protrusion of the inferior punctum was noted. It was also noted that the punctum blanched during this projectile movement compared to the rest of the lid margin. Simultaneous posterior rotation of the punctum was also observed in 48 eyes (85.7 per cent; 23 right eyes and 25 left eyes), resulting in apposition of the punctum to the lacus lacrimalis. In eight eyes (14.3 per cent; five right eyes and three left) from six patients, co-existence of medial punctal ectropion led to failure of internal rotation of the punctum during blinking, even though punctal 'pipette formation' was preserved. These six patients all suffered from epiphora in the affected eyes. The presence of 'pipette' formation was calculated to have a sensitivity of 80 per cent and specificity of 100 per cent for punctal ectropion in our series. A two-tailed Fisher exact test showed that based on our 56 eyes, these results were statistically significant (p < 0.0001). Conclusions: The inferior punctum plays an active and important role in the drainage of tears by the mechanism of supero-medial movement and medially directed protrusion ('pipetting action'), failure of which contributes to epiphora. This is a highly specific sign and should be sought in the evaluation of epiphora, even in the absence of frank ectropion. In punctual stenosis where location of the punctal orifice is proving difficult, inducing the pipette sign will help in its identification.

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Ultrasonic visualization of the effect of blinking on the lacrimal pump mechanism

Cited by 38 publications

References 23 publications

Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography

Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography

Ultrasonic 3D Reconstruction and Measurement of Lacrimal Sac in Normal Adult Chinese Population

Punctal function in lacrimal drainage: the ‘pipette sign’ and functional ectropion

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