Punctal dyeing: an adjunct to intraoperative lacrimal punctal identification

During lid operations, identifying the lacrimal punctum is sometimes difficult. The difficulty may be increased following local anesthetic infiltration into the medial canthus and manipulation of the lid tissues. Punctal dyeing with a skin marking pen is a simple technique that improves visualization of the lacrimal punctum during surgery in this region. Preceded by punctal dilatation, it lasts for the duration of standard lid or lacrimal procedures.