Management of Canalicular Injury Associated With Eyelid Burns

Purpose: To develop a protocol for treatment of injuries to the puncta and canaliculi associated with eyelid burns. Methods: We retrospectively reviewed the records of seven patients who required treatment of punctal and canalicular stenosis caused by burns to the medial eyelids. Results: Seven patients were treated within 5 days of injury: one by punctal dilation and six by surgical débridement, punctoplasty or canaliculoplasty, and silicone intubation. All remained free of epiphora. Conclusions: Early evaluation and treatment of punctal and canalicular burn injuries are beneficial. If the puncta are only slightly stenotic, close observation with serial lacrimal testing and punctal dilation is recommended. If the puncta and lateral canaliculi are severely stenotic or obliterated, surgical débridement and punctoplasty or canaliculoplasty followed by placement of a silicone stent effectively prevents permanent lacrimal stenosis and epiphora.