IN A RECENT publication, the use of penicillin in the lacrimal sac for the treatment of acute dacryocystitis was reported.1 It was surprising to note that the penicillin was introduced into the sac by means of a No. 20 hypodermic needle entered through the skin over the sac, after anesthetizing it with an injection of procaine hydrochloride. The introduction of the antibiotic into the sac can usually be accomplished by means of a curved lacrimal cannula introduced through the lower canaliculus without puncturing the skin, and with relatively little discomfort.
It does take longer to anesthetize the punctum and canaliculus when the tissues are acutely inflamed, but with care it can be accomplished.
A cocaine or tetracaine-soaked pledget sufficiently large to fill the medial canthus and cover the lower punctum thoroughly is left in contact for five minutes, and this procedure is repeated three times for the same length
HUGHES WL. ASPIRATION OF THE LACRIMAL SAC IN ACUTE DACRYOCYSTITIS. AMA Arch Ophthalmol. 1953;50(2):188. doi:10.1001/archopht.1953.00920030193008