[Your Name Appears here]
[Your section appears here]
[Professor’s name appears here]
[Date Appears here]
QUESTION 1:
Considering the scenario described in this case study, it looks as though the drainage and the flow of fluid in the anatomy of the eye is disturbed. The absence of redness and the unilateral presentation rules out infective causes though. There are many possibilities to how the patient presented. It could be the congenital obstruction or blockage of nasolacrimal duct in which tears are not properly circulated into the nasolacrimal apparatus. There is a possibility that this patient may have congenital glaucoma as well due to its non-infective symptoms or even an absent or stenosed puncta like in punctual atresia. On a rare instance, it could also be a neoplastic lesion leading to occlusive symptoms.
QUESTION 2:
The nasolacrimal apparatus consists of lacrimal gland, accessory lacrimal gland, lacrimal canaliculi, lacrimal punctum, lacrimal sac, nasolacrimal duct and its meatus.
The tears are synthesized in lacrimal and accessory lacrimal glands which forms the thin tear film over cornea. They then drain in to superior and inferior puncti in the medial part of eye flowing into the lacrimal sac via lacrimal canaliculi. From here, it is drained into the nasal cavity via nasolacrimal duct and it meatal opening in the nose.
QUESTION 3:
QUESTION 4:
The most commonly practiced maneuver done for the management of nasolacrimal duct obstruction is massaging. Parents are instructed to apply gentle pressure using single finger over canaliculi and massaging their way down to increase the pressure in lacrimal sac encouraging valve opening with gentle downward strokes.
The exercise should be done twice a day and should be stroked 10 times in each cycle.
