Treatment of canalicular block

Canalicular obstructions especially those of the inferior canaliculus present some of the most difficult problems in lacrimal surgery. Before surgery, the clinical examination must elicit the degree of discomfort and the length and position of the stenosis. If the stenosis is partial, a bincanalicular intubation is the treatment of choice, but if the stenosis is on the punctum or in the common canaliculus, or if the stenosis is limited, conservative surgery should be used. If the stenosis is long, one of the best methods of obtaining lacrimal drainage is by the use of Jones' procedure. However because post-operative complications are common this method has been modified by the use of a silicone tube introduced into the naso-lacrimal duct. This has now been performed for over 10 years.