The Lacrimal Canaliculus and Sac Bordered by the Horner's Muscle Form the Functional Lacrimal Drainage System

Kakizaki, Hirohiko; Zako, Masaru; Miyaishi, Osamu; Nakano, Takashi; Asamoto, Ken; Iwaki, Masaya

doi:10.1016/j.ophtha.2004.11.043

Cited by 100 publications

(59 citation statements)

References 19 publications

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“…11,13 The vertical portion is surrounded by the muscle of Riolan or Horner's muscle. 14 The canaliculus then turns horizontally in a medial direction parallel to the eyelid margin.…”

Section: Discussionmentioning

confidence: 99%

“…10,13,14 The negative pressure (vacuum effect) resulting from the subsequent expansion of the lacrimal sac is transmitted to the tear menisci via the elastic expansion of the canaliculi during the interblink interval. With ensuing relaxation of the orbicularis oculi muscle, the punctal areas separate and the vacuum is broken during the eyelid opening phase resulting in drainage of tear fluid from the marginal tear strip and lacus lacrimalis.…”

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confidence: 99%

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Punctal function in lacrimal drainage: the ‘pipette sign’ and functional ectropion

Beigi

Gupta

Luo

et al. 2015

Clinical and Experimental Optometry

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Background:The aim was to assess the movements of the inferior punctum during blinking and discuss pertinent clinical applications. Methods: This is a prospective, non-comparative observational case-series examining the function of inferior punctum during blinking using video recordings of the blinking action at the slitlamp with slow-motion analysis and comparison. Results: In all 56 eyes of 28 patents, supero-medial movement of the lower punctum toward the medial canthus, together with a medially directed protrusion of the inferior punctum was noted. It was also noted that the punctum blanched during this projectile movement compared to the rest of the lid margin. Simultaneous posterior rotation of the punctum was also observed in 48 eyes (85.7 per cent; 23 right eyes and 25 left eyes), resulting in apposition of the punctum to the lacus lacrimalis. In eight eyes (14.3 per cent; five right eyes and three left) from six patients, co-existence of medial punctal ectropion led to failure of internal rotation of the punctum during blinking, even though punctal 'pipette formation' was preserved. These six patients all suffered from epiphora in the affected eyes. The presence of 'pipette' formation was calculated to have a sensitivity of 80 per cent and specificity of 100 per cent for punctal ectropion in our series. A two-tailed Fisher exact test showed that based on our 56 eyes, these results were statistically significant (p < 0.0001). Conclusions: The inferior punctum plays an active and important role in the drainage of tears by the mechanism of supero-medial movement and medially directed protrusion ('pipetting action'), failure of which contributes to epiphora. This is a highly specific sign and should be sought in the evaluation of epiphora, even in the absence of frank ectropion. In punctual stenosis where location of the punctal orifice is proving difficult, inducing the pipette sign will help in its identification.

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“…11,13 The vertical portion is surrounded by the muscle of Riolan or Horner's muscle. 14 The canaliculus then turns horizontally in a medial direction parallel to the eyelid margin.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Punctal function in lacrimal drainage: the ‘pipette sign’ and functional ectropion

Beigi

Gupta

Luo

et al. 2015

Clinical and Experimental Optometry

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“…"anterior lacrimal crest") besitzt durchschnittlich eine Länge von 16,25 mm (Spanne: 13-19 mm) bis zum Eintritt in den Canalis nasolacrimalis, die hintere (posterior lacrimal crest) 12,75 mm (10-16 mm) [12]. Etwa in Hö-he der Mitte der hinteren Leiste inseriert der Hinterrand der Pars lacrimalis des M. orbicularis oculi 1,37 mm (1-2 mm) entfernt von der hinteren Leiste [12]. Der durchschnittliche Durchmesser der Fossa sacci lacrimalis beträgt oben 6,5 mm (6-7 mm), in der Mitte 9 mm (7-10 mm) und unten 6 mm (5-7 mm).…”

Section: Topographieunclassified

Anatomie und Physiologie der ableitenden Tränenwege

Paulsen

Garreis

Schicht

et al. 2016

HNO

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Ophthalmologists and interventional radiologists are not the only professionals for whom diseases of the efferent tear duct system occupy centre stage; this applies also to ENT specialists involving endonasal conservative or surgical treatment. On the basis of current knowledge and taking account of results yielded by own research in recent years and of clinical aspects, we here give an overview of basic knowledge on the anatomy and physiology of the nasolacrimal system. In doing so functional aspects regarding tear transport as well as embryological and pathophysiological issues are integrated.

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“…5 The horizontal portion of canaliculus is composed of collapsible tube which is surrounded antero-inferiorly by Horner's muscle, a specialised part of orbicularis oculi participating in lacrimal pump function. 6 The transition of vertical canaliculus into the horizontal portion is formed by a dilated structure called Ampulla. The normal horizontal portion of canaliculus has diameter ranging from 0.5 to 1.5 mm which varies along its length.…”

mentioning

confidence: 99%

“…The normal horizontal portion of canaliculus has diameter ranging from 0.5 to 1.5 mm which varies along its length. 3,6 Horizontal canaliculi are elastic structures and can dilate upto 2-3 times during manoeuvres. Any injury or trauma (mechanical, thermal, chemical or radiation) to the epithelial lining and surrounding tissue of lacrimal drainage system can potentially cause an aggressive healing response.…”

mentioning

confidence: 99%