Which of the following lists correctly orders the drainage pathway of tears from the tear film to the nasolacrimal duct?

• A. Puncta, lacrimal sac, canaliculi, nasolacrimal duct
• B. Canaliculi, puncta, lacrimal sac, nasolacrimal duct
• C. Puncta, canaliculi, lacrimal sac, nasolacrimal duct
• D. Nasolacrimal duct, lacrimal sac, canaliculi, puncta

Answer: (C)

Tear drainage follows the flow from the eye through the openings on the eyelids into the drainage channels, then into the lacrimal sac, and finally through the nasolacrimal duct to the nasal cavity. Tears first enter the puncta, the small openings at the medial edge of the eyelids. From each punctum, tears pass into a canaliculus; the superior and inferior canaliculi drain tears into the lacrimal sac. From there, tears move into the nasolacrimal duct. That sequence—puncta, canaliculi, lacrimal sac, nasolacrimal duct—matches the actual pathway. The other orders mix up the locations (for example, placing the lacrimal sac before the canaliculi or starting with the nasolacrimal duct), which doesn’t reflect how tears travel from the ocular surface to the nasal cavity.