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ask pt to “look down” as the dr slides up the outer part of the upper eyelids with their thumbs to check the lacrimal gland. There should be no swelling/redness. inspection lacrimal sac/nasolacrimal duct for swelling- if a problem suspected with lacrimal sac/nasolacrimal duct obstruction, then stand in front of the pt and ask pt to look up. ................
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