Improved Radiological Technique for Evaluating the Lacrimal Pathways With Special Emphasis on Functional Disorders

Montanara, A; Catalino, Pietro; Gualdi, M

doi:10.1111/j.1755-3768.1979.tb00503.x

Cited by 10 publications

(3 citation statements)

References 18 publications

(4 reference statements)

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“…Inspection of puncta, eye lid position, misplaced eye lashes and presence of lid laxity should be examined. 4,5 Evaluation of epiphora can be done by lacrimal syringing, fluorseceine dye disappearance test, 6 Jones dye test, contrast dacryocystography,nuclear lacrimal scintigraphy, [7][8][9] CT, MRI etc. These tests help us to identify site of obstruction and lacrimal pump failure.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of fluorescein dye disappearance test in comparison with lacrimal syringing in evaluation of epiphora

Dinesh P,

Irshad E,

Ramesan E C K

et al. 2023

IJCEO

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Epiphora is the overflow of tear in the lid margin. It can be due to hyper secretion or inadequate tear drainage. Inadequate drainage of tears may be due to mechanical or physiological causes. Physiological cause is due to lacrimal pump failure or weakness of orbicularis muscle. Mechanical causes are due to obstruction in the lacrimal passages. Evaluation of epiphora can be done by lacrimal syringing, fluoresceine dye disappearance test, Jones dye test, contrast dacryocystography, nuclear lacrimal scintigraphy, CT, MRI etc. Fluoresceine dye test is a non invasive method to study tear flow drainage system. Our study evaluate the effectiveness of dye disappearance test to lacrimal syringing which is a invasive test. Aim of this study was to evaluate the accuracy of fluorescein dye disappearance test [FDDT] in evaluating epiphora in comparison to lacrimal syringing.: A prospective observational study was conducted in 90 consecutive patients of age group of 40 to 70 years who presented with epiphora in Department of ophthalmology at tertiary care centre. Any cause like foreign body, trauma, blepharitis, lid disorders like ectropion, entropion, history of lacrimal sac surgeries in the recent past, and allergy to sodium fluorescein excluded from the study.A thorough medical history and comprehensive ophthalmological examination done in all patients. Epiphora evaluated with regurgitation over pressure on the lacrimal sac area, lacrimal syringing, and fluorseceine dye disappearance test.FDDT resulte were graded as grade 1 to 4 according to the quantity of flouorseceine stain in the conjunctival sac, Grade 1 and 2 considered as normal and grade 3 and 4 considered as abnormal.Results of FDDT, syringing, ROPLAS compared in the patients with epiphora.: In the study group, the 90 samples were analysed. The sample population were 62% males and 38% females. There were co-morbidities like diabetes mellitus and cataract noticed in the population. When we examined the diabetes mellitus patients presented with epiphora, showed lacrimal passage obstruction is more common in diabetes patients [67% patients among diabetes patients have FDDT of grade 2-3]. Regurgitation on pressure over lacrimal sac] test were done in all patients presented with epiphora, and the test was positive in 21 patients. FDDT were done in these patients and the results showed only 14 patients were Grade 2-3 [67%]. We compared the FDDT and lacrimal syringing tests in epiphora patients. Among the 90 patients we found that 60 individuals had patent nasolacrimal passages, verified by free flow in Lacrimal syringing test. FDDT showed majority of the patients were under grade 0-1 [patent nasolacrimal passages]. The patients with blocked nasolacrimal passages verified by lacrimal syringing were found grade 2-3 in FDDT [Blocked nasolacrimal passages]. Sensitivity, specificity, and positive and negative predictive value of FDDT were calculated.: FDDT is a safe and effective test for the evaluation of epiphora. It can be done as a screening test in pre operative evaluation of cataract surgery.

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Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of fluorescein dye disappearance test in comparison with lacrimal syringing in evaluation of epiphora

Dinesh P,

Irshad E,

Ramesan E C K

et al. 2023

IJCEO

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“…Although there is no consensus on definition, the term is currently often used for epiphora with no discernable cause but presumed outflow dysfunction, with subclassification into ‘pre‐sac’ and ‘post‐sac’ delays. Alternate nomenclatures include physiological dysfunction, 2 functional disorders, partial functional disorders, 3,4 functional nasolacrimal blockage 5 and functional acquired epiphora 6,7 . Other authors have elected to discard this terminology altogether, favouring a more descriptive approach, for example epiphora in the presence of a patent lacrimal system, 8 epiphora with patent syringing 9 or patent but non‐functioning lacrimal systems 10 .…”

Section: Introductionmentioning

confidence: 99%

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

Chan

Malhotra

Kakizaki

et al. 2012

Clinical Exper Ophthalmology

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The term 'functional block' is used to encompass the concept of lacrimal drainage dysfunction in the presence of anatomical patency. There is significant variability in the nomenclature, clinical and investigative criteria used in the literature to define this entity. This has led to confusion and lack of comparability of studies looking at this group. The clinical features, investigative findings and treatment options in this group of patients are described. In addition, the need to differentiate between nasolacrimal stenosis and 'functional block' is emphasized, as evidence suggest patients with nasolacrimal duct stenosis have better outcomes with dacryocystorhinostomy. To better define the disease entity and enable comparability of future studies, it was proposed that this entity be replaced by the term functional epiphora with no delay, pre- or post-sac delay.

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“…Patients who complain of epiphora without tear overproduction, but show easy passage on syringing are said to have functional lacrimal duct obstruction. This delayed or absent excretion of tears without anatomical obstruction of the lacrimal system has been shown to be caused by stenosis of the lacrimal system, aberrant punctum location, blocked flow through the punctum, or dysfunction of the lacrimal excretion pump [ 5 , 6 , 7 , 8 , 9 , 10 ]. Dacryoscintigraphy is an effective method of diagnosing functional lacrimal duct obstruction.…”

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confidence: 99%

Dacryoscintigraphic Findings in the Children with Tearing

Kim

Cho

Lee

2015

Korean J Ophthalmol

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PurposeTo investigate the diagnostic effectiveness of dacryoscintigraphy in children with tearing; to evaluate tear clearance rate as a diagnostic factor of dacryoscintigraphy in children with tearing; and to analyze the results of treatment according to dacryoscintigraphic findings in children with tearing.MethodsBetween January 2010 and April 2014, 176 eyes of 88 children with tearing (49 boys and 39 girls; mean age, 23.81 ±14.67 months; range, 12 to 72 months) were studied retrospectively. Of these, 37 of 88 children with tearing were bilateral cases, and 51 were unilateral cases. None of the patients had a history of craniofacial disorder or trauma. The chief complaint of tearing with or without eye discharge and delivery mode, past history of neonatal conjunctivitis, syringing, or probing were collected from parents, grandparents, or previous hospital data. The drainage pattern of the nasolacrimal duct was analyzed, and the clearance rate of 50 µCi 99m technetium pertechnetate was measured by dacryoscintigraphy.ResultsAccording to the dacryoscintigraphy results, 98 of 125 eyes (78.4%) with tearing showed nasolacrimal obstruction and 29 of 51 eyes (56.9%) without tearing showed patency. There was a significant difference between tearing eyes and normal eyes (p = 0.001). The clearance rate difference after 3 and 30 minutes was 16.41 ± 15.37% in tearing eyes and 23.57 ±14.15% in normal eyes. There was a significant difference between epiphoric eyes and normal eyes (p = 0.05). Based on the dacryoscintigraphic findings, nasolacrimal-duct obstruction was treated with probing or silicone-tube intubation. The majority of patients showed symptom improvement (75.2%) during the two months of follow-up.ConclusionsDacryoscintigraphy is a non-invasive method of qualitatively and quantitatively diagnosing nasolacrimal duct obstruction in children with tearing.

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Improved Radiological Technique for Evaluating the Lacrimal Pathways With Special Emphasis on Functional Disorders

Cited by 10 publications

References 18 publications

Diagnostic accuracy of fluorescein dye disappearance test in comparison with lacrimal syringing in evaluation of epiphora

Diagnostic accuracy of fluorescein dye disappearance test in comparison with lacrimal syringing in evaluation of epiphora

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

Dacryoscintigraphic Findings in the Children with Tearing

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