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A canalicular stenosis was identified in 29 of 66 (44%) children and 35 of 80 (44%) lacrimal drainage systems undergoing silicone intubation for congenital nasolacrimal duct obstruction, having previously had unsuccessful probings. The stenoses were equally divided between boys and girls and between right and left sides. There was no significant difference in age at the time of probing, number of prior probings, or age at intubation between children with and without canalicular stenosis. Stenoses may be congenital or acquired as a result of faulty probing. Any child undergoing a second lacrimal procedure after a failed probing should be evaluated for evidence of a canalicular stenosis. If a stenosis is present, a silicone stent should be placed to try to salvage the canaliculus.

A 72-year-old woman with chronic lymphocytic leukemia developed periorbital swelling, erythema, and discharge involving her anophthalmic left socket in the course of pseudomonas aeruginosa septicemia. Histopathologic examination of debrided eyelid tissues revealed ischemic necrosis of the eyelid margin and deeper eyelid tissues. Underlying malignancy, disseminated systemic infection, and alteration in the vascular supply to the eyelids following enucleation may have contributed to the development of ischemic eyelid necrosis in this patient.