Imperforate Lacrimal Punctum in Dogs

Tears occur naturally to lubricate your dog’s eyes and drain through the lacrimal punctum. Excessive tearing will occur when the lacrimal punctum, located at the corner of the eye, is not open. The tears will not have an outlet and will overflow onto your dog’s face. This can cause tear stains to appear.

Imperforate lacrimal punctum in dogs is a congenital disorder. It is when the opening to the nasolacrimal duct, or tear duct, is blocked. Dogs have two lacrimal puncta, the inferior and the superior and this condition can affect one or both of these. Any dog can develop imperforate lacrimal punctum, but there are specific breeds that are predisposed to it including the Samoyed, American Cocker Spaniel, Poodle, Bedlington Terrier, and Golden Retriever.

Some owners may not realize right away that there is a problem with their dog’s lacrimal punctum if their dog tears up easily from other outside influences such as dust or allergens. If you notice any changes to your dog’s eyes including the following symptoms, you should have them checked out by your veterinarian. 

• Watery eyes or epiphora
• Rust colored staining at the corner of the eye or down the face
• Excessive blinking or blepharospasm
• Rubbing the affected eye or scratching at the eye
• Swelling of the eye

Imperforate lacrimal punctum in dogs is an inherited disorder. This occurs when the lacrimal punctum in the tear duct becomes blocked. When it is blocked, the tears that lubricate the eye have no place to drain, except over the rim of the eye and down the face. Some dogs are born with blockages to the lacrimal punctum while others are born with very small openings that easily become blocked.

Your veterinarian will need a full medical history of your dog as well as the specifics of their diet. This will help them to determine if environment and diet are playing a role in the excessive tearing or if there is a medical problem that needs to be addressed. 

When diagnosing imperforate lacrimal punctum in your dog, your veterinarian will first try to flush the nasolacrimal duct, or tear duct, to try and determine if there is a blockage. If there is a blockage, the next step is to see if the imperforate punctum is blocked and causing the excessive tearing. 

A bacterial culture test may also be done to determine if the excessive tearing is being caused by an underlying bacterial infection. Some veterinarians may not be comfortable diagnosing eye diseases or conditions. If this is the case with your veterinarian, they will refer you to a specialist called a canine ophthalmologist.

Once imperforate lacrimal punctum has been diagnosed, your veterinarian or canine ophthalmologist will discuss the best treatment option for your dog. Many times this will include surgery to open the lacrimal punctum.

Your dog will be put under general anesthetic during the surgery. The nasolacrimal duct will be flushed with a sterile solution. This will show where the lacrimal punctum should be open. A small incision will be made to open the lacrimal punctum. 

To keep the opening from closing back up again after surgery, catheterization may need to be done for several weeks while healing from the surgery. Supportive care for your dog will be required during and after eye surgery. 

Post-surgical treatments will include antibiotic medications to reduce the risk of infection. Anti-inflammatory medications and antibacterial medications may also be prescribed. Be sure to follow all dosing instructions on medications prescribed. An Elizabethan collar will be required while your dog is healing from surgery.

While your dog recovers from surgery, post surgical eye checks will be required, generally once a month to check for any infection and to ensure that the lacrimal punctum is still open. 

While your dog is recovering from surgery do not allow them to play outdoors to reduce the risk of injuring the surgical site or getting debris into the eye. Keep your dog from aggravating the eye and causing inflammation that can cause it to become blocked again.

Once the lacrimal punctum has been opened surgically, you will need to maintain regular checks with your veterinarian or canine ophthalmologist to ensure that it is staying open and functioning properly. In some cases, the lacrimal punctum has to be reopened again surgically because the blockage has recurred.