Functional blockage

Functional blockage due to preductal or ductal narrowing, identified by delayed MDCG and scintigraphy can be treated by DCR and a silicone stent. Many cases of functional blockage have also been successfully treated using lid shortening and punctal snip procedures16. It seems that in such cases other underlying causes have been responsible such as punctal phimosis. Functional blockage due to pump failure (facial nerve palsy) might require by-pass lacrimal surgery. Treatment remains controversial.

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