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Acquired external punctal stenosis: etiology and associated findings.
Am J Ophthalmol. 2003 Dec; 136(6):1079-84.AJ

Abstract

PURPOSE; To investigate the underlying causes of acquired external punctal stenosis (AEPS) and assess the associated tear drainage problems.

DESIGN

Prospective, noncomparative observational case series.

METHODS

Seventy-eight eyes of 52 patients with symptomatic AEPS were prospectively assessed by or under supervision of a consultant oculoplastic surgeon from June 1999 to October 2002. The severity of the stenosis was graded on clinical examination. Associated findings from ophthalmic examination, diagnostic probing, and irrigation were recorded. The chi(2) test with 95% confidence interval (CI) and the Fisher exact test were used for statistical analysis.

RESULTS

The age range was 39 to 90 years (mean, 69.4 years). Acquired external punctal stenosis was due to chronic blepharitis in 35 eyes (45%), unknown etiology in 21 eyes (27%), ectropion in 18 eyes (23%), and related to drugs in 4 eyes (5%). Associated canalicular stenosis and common canalicular stenosis with obstruction (at the level of the internal punctum) was found in 36 eyes (46%) with AEPS. Nasolacrimal duct stenosis (5 eyes) or obstruction (2 eyes) was found in 8.5%. The number of patients with associated canalicular and common canalicular stenosis increased with increasing age (95% Confidence Interval [CI] = 0.03-0.04, P =.03) and duration of symptoms (95% CI = 0.02-0.03, P =.02). The number of patients with associated nasolacrimal duct stenosis and obstruction increased with increasing age (95% CI = 0.000- 0.001, P =.001) and in AEPS with unknown etiology (95% CI = 0.004-0.006, P =.003).

CONCLUSIONS

Chronic blepharitis is a common cause of AEPS even after treating the blepharitis, but in a significant number of patients there is no apparent etiology. Associated upper and lower tear drainage stenosis should be considered in the preoperative evaluation and surgical plan for AEPS.

Authors+Show Affiliations

Oculoplastic Service, Rassoul Akram Hospital, Iran University of Medical Sciences,Tehran, Iran.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14644218

Citation

Kashkouli, Mohsen Bahmani, et al. "Acquired External Punctal Stenosis: Etiology and Associated Findings." American Journal of Ophthalmology, vol. 136, no. 6, 2003, pp. 1079-84.
Kashkouli MB, Beigi B, Murthy R, et al. Acquired external punctal stenosis: etiology and associated findings. Am J Ophthalmol. 2003;136(6):1079-84.
Kashkouli, M. B., Beigi, B., Murthy, R., & Astbury, N. (2003). Acquired external punctal stenosis: etiology and associated findings. American Journal of Ophthalmology, 136(6), 1079-84.
Kashkouli MB, et al. Acquired External Punctal Stenosis: Etiology and Associated Findings. Am J Ophthalmol. 2003;136(6):1079-84. PubMed PMID: 14644218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acquired external punctal stenosis: etiology and associated findings. AU - Kashkouli,Mohsen Bahmani, AU - Beigi,Bijan, AU - Murthy,Rachna, AU - Astbury,Nick, PY - 2003/12/4/pubmed PY - 2003/12/17/medline PY - 2003/12/4/entrez SP - 1079 EP - 84 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 136 IS - 6 N2 - UNLABELLED: PURPOSE; To investigate the underlying causes of acquired external punctal stenosis (AEPS) and assess the associated tear drainage problems. DESIGN: Prospective, noncomparative observational case series. METHODS: Seventy-eight eyes of 52 patients with symptomatic AEPS were prospectively assessed by or under supervision of a consultant oculoplastic surgeon from June 1999 to October 2002. The severity of the stenosis was graded on clinical examination. Associated findings from ophthalmic examination, diagnostic probing, and irrigation were recorded. The chi(2) test with 95% confidence interval (CI) and the Fisher exact test were used for statistical analysis. RESULTS: The age range was 39 to 90 years (mean, 69.4 years). Acquired external punctal stenosis was due to chronic blepharitis in 35 eyes (45%), unknown etiology in 21 eyes (27%), ectropion in 18 eyes (23%), and related to drugs in 4 eyes (5%). Associated canalicular stenosis and common canalicular stenosis with obstruction (at the level of the internal punctum) was found in 36 eyes (46%) with AEPS. Nasolacrimal duct stenosis (5 eyes) or obstruction (2 eyes) was found in 8.5%. The number of patients with associated canalicular and common canalicular stenosis increased with increasing age (95% Confidence Interval [CI] = 0.03-0.04, P =.03) and duration of symptoms (95% CI = 0.02-0.03, P =.02). The number of patients with associated nasolacrimal duct stenosis and obstruction increased with increasing age (95% CI = 0.000- 0.001, P =.001) and in AEPS with unknown etiology (95% CI = 0.004-0.006, P =.003). CONCLUSIONS: Chronic blepharitis is a common cause of AEPS even after treating the blepharitis, but in a significant number of patients there is no apparent etiology. Associated upper and lower tear drainage stenosis should be considered in the preoperative evaluation and surgical plan for AEPS. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/14644218/Acquired_external_punctal_stenosis:_etiology_and_associated_findings_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002939403006640 DB - PRIME DP - Unbound Medicine ER -