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THE GENERAL principles in the management of the obstructed lacrimal passage are well delineated. Although differences of opinion do exist regarding specific indications for therapy, competent clinicians agree that the most physiologic and least traumatic approach in each case is desirable. Each case must be carefully evaluated on the basis of such factors as the age of the patient, the duration of obstructive symptoms, the acuteness of the process, the presence or absence of collateral cellulitis, the cause of the obstruction and the previous therapy. An adequate assessment having been made, it ultimately becomes necessary to determine (1) whether the stenosis is due to cicatrix or to inflammatory infiltration and edema and (2) the degree of the closure.
Most methods for establishing the patency of the lacrimal system consist of irrigation into the nose via the upper or the lower canaliculus. Many times such a regimen fails because the block