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ChapterFiveLacrimalapparatusdiseaseTearsecretionandexcretionLacrimalductstenosisorobstructionEtiology:(1)functionalepiphora:Noobviousoflacrimalductobstruction,Lacrimalductflushingflux,theprimarycauseistheorbicularisoculimusclerelaxation,causeeyelidandabnormallacrimalpointlocation,lacrimalpointcan'ttouchtearlake,tearpumpactionweakenedordisappeared,tearscannotenterthelacrimalduct.(2)Organictearsoverflow:Obstructionorstenosisofthenasolacrimalducttothenasolacrimalduct.Clinicalmanifestation:ThemainsymptomisoverflowoftearsObstructionoccurredattheendofthenasallacrimalsacandhaddacryocystitis,withpurulentsecretionsflowingbackintotheconjunctivalsacTreatmentDeterminingthelocationoftheobstructionisimportantforthechoiceoftreatmentoptionsCommoninspectionmethods:a、Thedyetest(2%uraninsolution)ismainlyusedforchildrenb、Irrigationoflacrimalpassagec、Probingoflacrimalpassaged、XraylipiodolradiographyshowedsizeandobstructionofthelacrimalsacPosition。Commontreatment（1）Stenosisorobstructionoflacrimalductininfants：Duetothehypoplasiaofthelowerendofthenasolacrimalduct,thereisno“duct”ormembranousobstruction.Tryfingerregularcompressionoflacrimalsacarea,sincetheorbitallinebetweenthemedialandeyedownoppression,oppressionafterseveralantibioticseyewater,3-4timesaday,persistforseveralweeks,mostchildrencanbecured,ifconservativetreatmentisinvalid,halfayearafterconsideringthelacrimalpassage。NeonataldacryocystitisEpiphoraandmattingInfrequentlyacutedacryocystitisProbingoflacrimalpassageAfterapplicationofatopicalanesthetic,theprobeiscarefullyintroducedintothelowerlacrimalsystem.ThepunctaaredilatedandthenthevalveofHasnerisopened(aandb).Ininfantssixmonthsorolder,theprocedureisbestperformedundershort-actinggeneralanesthesia.（2）Functionaltearoverflow：Trythezincsulfateandadrenalinesolutiondrops,shrinkageoftearsCysticmucosa。（3）Stenosis,occlusion,orabsenceoftear：Dilateordetectwithadilator.Eversionofthelowerpartoftheeyelidduetoectropioncancorrectectropion。（4）Lacrimalcanaliculiobstruction：Thelasertreatmentmethodguidesthefibertotheblockingpositionthroughtheprobe,andusesthegasificationeffectofthepulseYAGlasertobreaktheobstruction,andaftertheoperation,theintubationorthethreadisaddedtoimprovethecurativeeffect。（5）Nasolacrimalductstenosis：FeasibledacryocystorhinostomyTwo：ChronicdacryocystitisMorecommoninmiddle-agedandelderlywomenEtiology：Nasolacrimalductstenosisorobstruction,resultingintearsstuckinthelacrimalsac,accompaniedbybacterialinfection.CommonpathogenicbacteriaareStreptococcuspneumoniae,Streptococcus,StaphylococcusandsoonChronicdacryocystitisEpiphoraandchronicorrecurrentunilateralconjunctivitisPainlessswellingatinnercanthusExpressedmucopurulentmaterialTreatment-DCRClinicalmanifestation：Themainsymptomisoverflowoftears.Squeezingtheareaofthelacrimalsacwiththefingers,leavingmucusorpurulentdischargefromthelacrimalpoint.Whenthelacrimalpassageisflushed,theirrigatingfluidflowsbackfromtheupperandlowerlacrimalpoints,andhasmucoussecretionsatthesametime.Hyperemiaofthebulbarconjunctivaoccursduetosecretionstimulation.Asthesecretionremains,thetearsacexpandsandformsmucoceleofthelacrimalsac。Treatment（1）Drugtreatment:availableantibioticeyedropsofwater(0.25%chloramphenicol,eyewater,q2h,0.1%furosemide,nosedrops,noseTID)dropfirst,thenremovethesecretionsortea...