This lady’s lower eyelid is drooping due to paralysis. She suffers from constant pooling of tears, which interferes with vision.
The picture is worth a thousand words. Fluorescein staining shows a HUGE tear volume. In a normal eye, this should be less than 0.3mm high, but here it is over 7mm high.
The treatment is in stages. First, I correct the drooping of the lower eyelid, then I insert a Jones tube, which is a tear drain bypass tube, essentially a new tear drain to do what her tear drain can no longer do.
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