Canalicular Injuries

Canaliculi are the mucosal tubes lined by non-keratinizing squamous epithelium, located in the lacrimal portion of upper and lower eyelids. Lacrimal canaliculi connect the punctum to the lacrimal sac and play a vital role in draining tears from the lacus lacrimalis to the lacrimal sac by the lacrimal pump mechanism. Any trauma which detaches the eyelid from its strong medial canthal tendon attachments can lacerate the canaliculi. Injury in the medial canthal region affects the tear drainage system by compromising the lacrimal drainage pathway (anatomically) and the lacrimal pump function (physiologically). If not managed appropriately, it may lead to persistent clear-fluid epiphora. Hence, it becomes essential for the operating surgeon to understand the complex anatomy of this area while repairing a canalicular laceration.