Punctal stenosis: definition, diagnosis, and treatment

Soiberman, Uri; Kakizaki, Hirohiko; Selva, Dinesh; Leibovitch, Igal

doi:10.2147/opth.s31904

Cited by 77 publications

(88 citation statements)

References 44 publications

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“…In addition, chronic blepharitis-related inflammation and cicatricial changes, ectropion, and old age-related tissue atrophy have also been implicated in punctum stenosis [11]. Similarly, another study reported punctum stenosis to be significantly higher in women [12].…”

Section: Discussionmentioning

confidence: 99%

How Important Is the Etiology in the Treatment of Epiphora?

Ulusoy

Kıvanç

Atakan

et al. 2016

Journal of Ophthalmology

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Purpose. There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients. Materials and Methods. Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination. Results. This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1–92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years (p = 0.012) and six of these had chronic dacryocystitis and one had ectropion. Conclusion. Epiphora not only has a negative impact on patients' comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied.

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Section: Discussionmentioning

confidence: 99%

How Important Is the Etiology in the Treatment of Epiphora?

Ulusoy

Kıvanç

Atakan

et al. 2016

Journal of Ophthalmology

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“…Patients with known systemic or pharmacologic etiologies for punctal stenosis were excluded. These etiologies have been described in the literature previously 1 , and include autoimmune disease, infectious agents, eyelid malposition, chronic blepharitis, topical ocular therapy, and systemic chemotherapy. Institutional review board approval was obtained from UIHC with a waiver of consent due to the retrospective nature of the study.…”

Section: Methodsmentioning

confidence: 99%

“…These include infectious causes, such as Actinomyces; autoimmune and inflammatory conditions, such as chronic blepharitis, ectropion, and graft-versus-host disease; and both topical and systemic medications, such as taxanes and topical glaucoma medications. 1 …”

Section: Introductionmentioning

confidence: 99%

Immunopathology and histopathology of conjunctival biopsies in patients with presumed idiopathic punctal stenosis

et al. 2016

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Background/Aims Numerous processes have been implicated as causes of punctal stenosis. Recent studies have highlighted inflammation in punctoplasty specimens in patients with punctal stenosis. Conjunctival biopsy has been suggested as a means to determine underlying etiologies, although little is known regarding what conjunctival pathologies are associated with punctal stenosis. Our objective is to examine the pathologic and immunologic findings in conjunctival biopsy specimens in patients with presumed idiopathic punctal stenosis. Methods A retrospective chart review was performed at a single institution over a five year period of patients with presumed idiopathic punctal stenosis who underwent conjunctival biopsy for routine histopathologic and/or direct immunofluorescent (DIF) examination. Patients with known etiologies of punctal stenosis were excluded. Results 23 patients met inclusion criteria. Conjunctival biopsies (n = 36) from all 23 patients underwent histological examination. 35 of 36 specimens (97.2%) showed a lymphocytic infiltrate. Two patients (8.7%) had findings suggestive of sarcoidosis. Conjunctival biopsies from 18 of the 23 patients were also evaluated by DIF. Nine patients (50.0%) had fibrinogen characteristics suggestive of lichen planus. There were no complications related to the conjunctival biopsy procedures. Conclusion Conjunctiva appears to be an excellent proxy in the evaluation of patients with presumed idiopathic punctal stenosis. The biopsy is safe and provides ample tissue. 11 of the 23 patients in this study demonstrated findings consistent with underlying immunologic disorders, suggesting that conjunctival biopsy may play a role in identifying the underlying etiology of punctal stenosis. Knowledge of these underlying conditions impacted medical and surgical treatments for several patients.

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“…Punctal stenosis is defined as a condition, in which there is narrowing or occlusion of the external opening of the lacrimal canaliculus, leading to epiphora . The condition is commonly diagnosed in human patients.…”

Section: Introductionmentioning

confidence: 99%

“…The pathogenesis is not completely understood, but it is most commonly associated with chronic blepharitis that leads to fibrosis and occlusion of the nasolacrimal puncta. There is no consensus in the human literature on how to define punctal stenosis within the research setting, or even what classifies punctal stenosis as a debilitating condition . Known causes of punctal stenosis in humans include some topical ophthalmic medications, some systemic chemotherapeutic agents, chronic blepharitis or conjunctivitis, dry eye disease, eyelid malformation, and neoplasia .…”

Section: Introductionmentioning

confidence: 99%

Punctal stenosis in 6 dogs following the long‐term use of topical neomycin‐polymyxin B‐dexamethasone

Quantz

Stiles

2018

Veterinary Ophthalmology

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Six dogs were diagnosed with punctal stenosis following the long-term use of topical neomycin-polymyxin B-dexamethasone (NPD). All patients were initially presented for ophthalmic diseases requiring ongoing anti-inflammatory therapy. Five of the 6 dogs had previously or concurrently been treated with topical anti-inflammatory medications other than NPD. One patient exclusively received topical NPD prior to the diagnosis of punctal stenosis. The onset of punctal stenosis following therapy with NPD was variable among patients, ranging from 4 months to over 1 year. Diagnosis of punctal stenosis was made based upon the presence of epiphora and visualization of fibrotic tissue over the nasolacrimal puncta.

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Punctal stenosis: definition, diagnosis, and treatment

Cited by 77 publications

References 44 publications

How Important Is the Etiology in the Treatment of Epiphora?

How Important Is the Etiology in the Treatment of Epiphora?

Immunopathology and histopathology of conjunctival biopsies in patients with presumed idiopathic punctal stenosis

Punctal stenosis in 6 dogs following the long‐term use of topical neomycin‐polymyxin B‐dexamethasone

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