Summary of surgical approaches
| Mild | Moderate | Severe |
|---|---|---|
| LCT repair | Plication of MCT posterior limb | Medial tarsal strip |
| ± medial spindle | or | or |
| ± open punctum | LCT repair | MCT resection (posterior limb) with canaliculus intubation/marsupialisation |
| ± resection of caruncle/semilunar fold | ± medial spindle | |
| ± open punctum, | or | |
| ± resection of caruncle/semilunar fold | MCT plication | |
| ± LCT repair |