Evaluation of canalization of the canaliculus with digital photo system for treating dry eye

Abstract

PURPOSE: We developed a simple evaluation technique of canalization of canaliculus by observing sequential images of the meniscus height after instillation of fluorescein solution. SUBJECTS AND METHODS: We used nine eyes of eight patients [one male eye, eight eyes of seven females, age: 68.3 +/- 15.9 (mean +/- standard deviation)] whose punctal plugs were extruded due to granulation formation within the canaliculi. Fluorescein solution was instilled into the eyes, until the tear meniscus was of sufficient height. Then the tear meniscus at the center of the lower lid margin was photographed with a slit-lamp equipped with a digital camera every three minutes for 15 minutes. These sequential photographs were displayed on the screen of a personal computer and from these photographs, canalization of the canaliculus was evaluated. RESULTS: In six eyes of six subjects, the meniscus height was remarkably diminished with time and the meniscus showed significant decrease as late as 15 minutes. In three eyes of two subjects, no remarkable decrease was noted during the 15 minutes. CONCLUSION: This simple method can be usefully applied in a clinical situation, because canalization of the canaliculus is easily evaluated just looking at the sequential meniscus images on the computer display.