Clinical History

This is a 15-year-old female who is status post motor vehicle accident, with resultant lacrimal duct stenosis on the left.

Technique

Before the procedure, the patient was instructed to massage the tear duct on the left side. The patient was administered 200 microcuries of technetium-99m pertechnetate in 10 microliter droplets into the conjunctival sacs bilaterally. Both serial dynamic and static images were obtained.

Findings

Rapid excretion of activity on the right lacrimal duct into the nasal passage is demonstrated at 5 minutes on the right. On the left, there is significant pooling of activity superiorly in the lacrimal duct with activity in the nasal passage not occurring until after 15 minutes.

Impressions

POOLING OF ACTIVITY IN THE LEFT LACRIMAL DUCT, CONSISTENT WITH INCOMPLETE OBSTRUCTIVE STENOSIS OF THE LEFT LACRIMAL DUCT. DELAYED FLOW THROUGH THE LEFT LACRIMAL DUCT AS COMPARED WITH THE RIGHT, IS ALSO CONSISTENT WITH INCOMPLETE OBSTRUCTIVE STENOSIS OF THE LEFT LACRIMAL DUCT.

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