Efficacy of dye disappearance test and tear meniscus height in diagnosis and postoperative assessment of nasolacrimal duct obstruction

Abstract

ABSTRACT.Objective: To evaluate the efficacy of the fluorescein dye disappearance test (FDDT) and measurement of tear meniscus height (TMH) in the diagnosis and postoperative assessment of nasolacrimal duct obstruction (NLDO). Methods: The study group included 42 eyes of 42 patients who had a diagnosis of primary acquired nasolacrimal duct obstruction (PANDO) or functional nasolacrimal duct obstruction (FNDO) and underwent endoscopic transnasal dacryocystorhinostomy. The control group included 38 eyes of 38 people without tearing. The values of the FDDT, TMH and tearing symptom score (TSS), which was evaluated in five levels based on patients' history taking, were measured before surgery, and 1 day, 2 weeks, 1, 3 and 6 months after surgery. The values of the FDDT, TMH and TSS in the study group were compared with those of the control group. Results: The preoperative values of the FDDT, TMH and TSS were 0.7 ± 0.4, 0.22 ± 0.08 mm and 1.6, respectively, in the control group and 3.0 ± 0.8, 0.53 ± 0.15 mm and 4.4, respectively, in the study group. These differences were statistically significant. Also, at each follow-up, the postoperative values of the FDDT and TMH decreased significantly compared to their preoperative values in the study group. The postoperative TSS decreased significantly compared to the preoperative values at each follow-up except at postoperative 1-day follow-up. There were no significant differences in the preoperative values of the FDDT, TMH and TSS between the types of NLDO. The TSS had positive correlations with the FDDT and TMH before and after surgery. Conclusion: These results suggest that the FDDT and TMH measurement might be effective in the diagnosis and postoperative assessment of NLDO.

Change in quality of life of patients undergoing silicone stent intubation for nasolacrimal duct stenosis combined with dry eye syndrome

“…The TMH measurement is useful to identify a disorder of the lacrimal drainage system and to postoperatively assess a nasolacrimal duct disorder 19 20. Various techniques (eg, slit lamp, optical coherence tomography and videomeniscometry) have been applied to accurately measure TMH.…”

Reliability of Fluorescein Dye Disappearance Test in Assessment of Adults With Nasolacrimal Duct Obstruction

“…6,[13][14][15][16][17][18][19][20][21][22] Lacrimal drainage system obstruction may be correlated with by aging. 14 Different reported reliability indices might be attributed to FDDT grading system, population selection, effect of fluorescein volume (drop or strip usage), number of strips, location of fluorescein placement, position of head during the test, and type of lacrimal obstruction.…”

Perspective: what does the term functional mean in the context of epiphora?

“…For clinical tests, such as TFH, FDDT and Jones dye test, the utility of demonstrating lacrimal drainage dysfunction is well established 16–20 . However, their role in diagnosing functional block is less clear because investigators do not distinguish between nasolacrimal stenosis and true functional block 9,20,21 . The utilization of these tests in assessment of functional block is also highly variable 5,7 .…”

“…FDDT may be more sensitive in identifying both normal and abnormal lacrimal systems compared with the Jones dye test 19 . However, there are no statistical differences when comparing TFH and FDDT values of functional and complete nasolacrimal duct obstruction (NLDO) 20,21 . This limits the role of TFH and FDDT to primarily demonstrating the presence of lacrimal dysfunction.…”