Lacrimal pump pressure patterns.

In most cases the tracings of lacrimal pump pressure patterns may be interpreted, but, should only be used in conjunction with the patient's history and physical examination. A Schirmer and a distraction test should be included. The distraction test is important in order to indicate the magnitude of the lid tension and thereby the integrity of one of the components of the lacrimal pump. A variety of clinical entities were presented and correlation between these entities and their lacrimal pump pressure recordings were made. These pressure patterns evolved from 75 monitored lacrimal drainage problem cases. In rare circumstances the silicone tube could not be inserted where no pathology existed. Stenotic puncta or closed systems cause sharp spikes indicative of high pressure and poor flow. Tightening of the lower lid can significantly increase pressure patterns and increase tear transportation. Tightening of the levator palpebrae superioris may increase pressures in the nasolacrimal system. Monitoring of canalicular and lacrimal pressures is an effective means of determining the patency of a DCR and conjunctival DCR. Nasolacrimal system monitoring is a safe, painless and effective method of evaluating disorders within that system.