Punctal Dilation & Lavage
A simple, usually painless procedure that widens the tear duct opening and flushes it with fluid to check for and help relieve a blockage.
What is punctal dilation and lavage?
Punctal dilation and lavage is a procedure used in the diagnosis and treatment of tear duct obstruction or tear drainage problems. The tear ducts keep the eye surface moist by draining tears from the eye toward the nose. However, in some cases these ducts can become blocked or narrowed. Punctal dilation is the procedure of widening the tear duct, after which fluid is passed through the duct with a lavage (washing) procedure to check whether there is a blockage. This procedure is usually applied in patients with symptoms such as constant watering (epiphora), discomfort in the eye, or frequently recurring infections.
In which situations is punctal dilation and lavage performed?
Punctal dilation and lavage is performed by ophthalmologists in cases where the tear ducts are not working properly. This procedure can be used in the following situations. Constant watering in the eye: due to tear duct obstruction or narrowing, tears cannot flow toward the nose and there is constant tearing (epiphora). Eye infections: blocked tear ducts can increase the risk of infection in the eye, and when the tear duct is not open, infections can recur frequently. Evaluation of the tear duct: lavage is used as a diagnostic test to check the openness and function of the tear duct. This procedure is performed to see how the tear duct is working.
How is punctal dilation and lavage performed?
This procedure is a simple and usually painless one. It is used to diagnose a blockage in the tear duct and to treat it when necessary. The procedure consists of the following steps.
Stages of the procedure
Preparation: before the procedure, the area around the eye is cleaned. Local anesthetic drops are applied so that no pain is felt in the eye. Punctal dilation: the doctor widens the tear duct opening called the punctum, located at the inner corner of the eyelid, with a special instrument. The punctum is the entrance to the ducts that allow tears to flow from the eye to the nose. Dilation helps open these blocked or narrowed ducts. Lavage (washing): after the punctum is widened, the doctor injects physiological saline (salt water) through the duct with the help of a small syringe. This fluid is used to check whether there is any blockage in the tear duct. If the fluid reaches the nose, the tear duct is open. However, if the fluid does not reach the nose, there may be a blockage in the tear duct and additional treatment may be required. Final check: once the lavage procedure is completed, the doctor checks the openness of the tear duct. If a blockage is detected, further treatments may be needed.
After punctal dilation and lavage
This procedure is usually painless, and the patient can return to daily life after the procedure. However, some patients may feel mild discomfort or watering in the eye after the procedure. This usually passes within a short time.
Things to watch for after the procedure
Follow-up of the tear duct: if the blockage is not fully opened, your doctor may recommend additional treatments. These may include eye drops, antibiotic treatment, or further surgical interventions.
The advantages of punctal dilation and lavage
A quick and effective procedure: punctal dilation and lavage is an effective and quick method for the diagnosis and treatment of tear duct obstruction. Painless and minimally invasive: this procedure is painless and can be performed comfortably under local anesthesia. Diagnosis and treatment: it both provides the diagnosis of tear duct obstruction and is a therapeutic procedure for opening the blockage.
The risks of punctal dilation and lavage
This procedure is generally a safe one, but, although rare, there may be some risks. Irritation in the eye: temporary irritation may occur in the eye while the punctum is being widened or during the lavage. Temporary risk of infection: there may be a mild risk of infection in the eye after the procedure, but the antibiotic eye drops recommended by your doctor minimize this risk. Recurrence of the blockage: if the tear duct is not fully opened, the blockage may recur. In this case, further surgical interventions may be required.
Do not postpone treatment!
If you are experiencing symptoms such as constant watering, crusting, or infection in the eye, you may have a tear duct obstruction. Punctal dilation and lavage is an effective method for the diagnosis and treatment of this problem. With early intervention, you can protect your eye health and prevent more serious complications.
This page is for general information and does not replace a personal examination. The right approach is decided together after an eye examination.