What Is Lacrimal Syringing?

Purpose of Lacrimal Syringing

Lacrimal syringing is commonly used as part of an evaluation for epiphora.

• Confirm whether the lacrimal drainage pathway is patent
• Help identify the level of narrowing or blockage based on reflux patterns
• Flush mucus or debris that may worsen symptoms

How the Test Is Done

1. The punctum is gently dilated, then a lacrimal cannula is placed into the canaliculus.
2. Saline is injected slowly while the clinician observes for free flow into the nose or reflux from the puncta.
3. The patient may be asked whether they feel fluid in the throat or taste saline, which can indicate nasal passage of the irrigant.

Probing may be added if the cannula cannot be advanced or if obstruction is suspected.

How Results Are Interpreted

Findings help distinguish patency from different obstruction sites.

• Free flow into the nose suggests a patent system.
• Reflux from the opposite punctum can suggest common canaliculus or distal obstruction.
• Reflux from the same punctum with difficulty advancing the cannula can suggest canalicular obstruction.

Because technique and pressure can affect results, clinicians may repeat testing or confirm with imaging when needed.

Risks and Precautions

Most people tolerate syringing well, but temporary discomfort, watering, and mild bleeding from the punctum can occur. The test is generally avoided or performed with caution in acute dacryocystitis because forcing fluid can worsen infection. Children or anxious patients may need additional support or anesthesia for safe testing. Seek care for increasing pain, swelling near the inner corner, fever, or significant discharge after the procedure.