Nasolacrimal irrigation helps assess tear-drainage patency and guide further care. It is performed after examination and exclusion of conditions that make the procedure unsuitable.
persistent or recurrent tearing after ophthalmic assessment; tear retention with suspected punctal, canalicular or nasolacrimal narrowing; recurrent discharge from the lacrimal pathway when the clinician considers irrigation safe and diagnostically useful;
before selecting further management when impaired tear drainage is suspected;
selected postoperative or inflammatory cases at the ophthalmologist’s discretion;
adults and children only within an age-appropriate pathway, without applying adult technique automatically to infants.
Do not insert needles, cannulas or solutions into the punctum yourself and do not attempt forceful flushing at home.
After tears spread across the ocular surface, they collect medially and enter the upper and lower puncta, then the canaliculi, lacrimal sac and nasolacrimal duct. Obstruction or dysfunction at any level can cause tear retention and epiphora.
known intolerance to an anesthetic or irrigating solution when relevant.
ocular-surface irritation, dry eye and conjunctival inflammation can cause reflex tearing without mechanical obstruction;
ectropion, entropion, lacrimal pump weakness or punctal malposition require separate assessment.
acute painful swelling and redness over the lacrimal sac;
suspected cellulitis or abscess of the lacrimal sac;
recent trauma to the lacrimal canaliculi or face without prior surgical assessment;
Book an ophthalmology assessment for persistent unexplained tearing, especially if unilateral or accompanied by tear retention or discharge.
Tell the doctor about eyelid or nasal surgery, facial trauma, chronic sinus disease, long-term eye-drop use and previous dacryocystitis .
Painful swelling and redness at the inner corner of the eye, pus, fever, bloody tears or worsening vision require a more urgent examination.
rapidly increasing pain and swelling at the medial canthus;
fever with lacrimal sac inflammation;
unexplained bloody tears;
severe photophobia or marked ocular pain;
medial eyelid trauma with possible canalicular laceration.
An examination is required prior to the procedure: tearing may be associated with dryness, inflammation, or eyelid malposition. In the case of trauma, painful swelling of the lacrimal sac, or drug intolerance, elective manipulation is postponed pending physician evaluation. Rapidly increasing pain and swelling, fever, blood in the tears, severe photophobia, or trauma to the medial canthus require immediate medical attention.
Book a consultation
The doctor reviews tearing, whether one or both eyes are affected, discharge, surgery, injuries, nasal disease and previous procedures.
The ocular surface, lid position, puncta, tear-meniscus height and lacrimal-sac area are assessed.
The doctor considers whether tearing relates to dry eye, inflammation, irritation or eyelid malposition.
A local anaesthetic is used if needed;
A special cannula is gently introduced through the punctum into the canaliculus.
Sterile solution is delivered under control; the doctor assesses resistance, flow direction and reflux.
The result is compared with examination findings to suggest the obstruction level or confirm anatomical patency.
Observation, additional tests, probing, intubation, surgical consultation or surgery are arranged when needed.
Irrigation allows fluid passage through the tear pathways to be assessed and a therapeutic procedure performed when indicated.
The pattern of fluid passage and reflux helps the doctor assess a possible drainage obstruction.
Irrigation findings help determine whether observation is sufficient or further investigations and procedures are needed.
Standard irrigation is performed through the natural tear puncta without a surgical skin incision.
Book an ophthalmology consultation at KazRIED. The doctor will determine the cause of tearing, assess the puncta and drainage system, and decide whether irrigation or another diagnostic or treatment method is appropriate.
A team of experienced doctors across specialties.
Highest-category ophthalmologist
Highest-category ophthalmologist
Highest-category ophthalmologist
First-category ophthalmologist
Second-category ophthalmologist
Second-category ophthalmologist
Second-category ophthalmologist
Excessive tearing is a symptom that may result from increased tear production or impaired drainage. Its cause is determined by examining the ocular surface, eyelids, and lacrimal drainage system.
After spreading across the ocular surface, tears collect near the inner eyelid corner. They pass through the upper and lower puncta into the canaliculi, then into the lacrimal sac and nasolacrimal duct. A problem at any of these levels may cause tear pooling and epiphora — excessive tearing.
Lacrimal irrigation is an anatomical test of drainage system patency.
After examining the punctum and canaliculus, the clinician inserts a special cannula and gently introduces a sterile solution.
Free passage into the nose or nasopharynx supports anatomical patency. Resistance and reflux from the same or opposite punctum help identify the possible level of narrowing.
The result is always interpreted alongside the examination findings.
Free irrigation does not exclude functional epiphora. The system may be anatomically open, yet drainage can remain slow because of lacrimal pump dysfunction, eyelid malposition, or other causes.
For example, irrigation does not correct punctal malposition caused by ectropion. Additional tests may be needed if tearing persists.
Irrigation may help identify a mechanical obstruction, but it does not replace probing, intubation, or surgical restoration of drainage when these are needed.
Patients traveling from another city should confirm which KazRIED location performs the required procedure and whether a preliminary consultation is needed.
Adult or pediatric ophthalmology consultations are charged separately unless included in another assessment or treatment program.
The procedure is prescribed after identifying the cause and level of the problem. Tearing alone is insufficient to determine whether irrigation is appropriate.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
