What ocular condition is diagnosed when a 26 gauge needle cannula cannot intubate the puncta?

• A. Canaliculitis
• B. Blepharitis
• C. Punctal stenosis
• D. Dacryocystitis

Answer: (C)

The situation tests how well the tear drainage openings (puncta) are pathed. When a 26-gauge cannula cannot pass through the punctum, it points to narrowing right at the punctal opening—the punctal stenosis. This is why that choice fits best: the punctum is too constricted to admit the small cannula, signaling a stenosis.

Other conditions involve infection or inflammation that affect nearby structures but don’t inherently block the punctal opening itself. Canaliculitis is infection of the canaliculus and may cause discharge or swelling along the canaliculus; blepharitis is lid margin inflammation; dacryocystitis is infection of the lacrimal sac and usually presents with swelling and tenderness near the lacrimal sac, not a primary blockage at the punctum.