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Year : 2020  |  Volume : 21  |  Issue : 4  |  Page : 268-274

Symptomatic acquired lacrimal passage obstruction: clinical evaluation of the level of obstruction in adult patients

Department of Ophthalmology, Minia University Hospital, Minia University, Minia, Egypt

Correspondence Address:
MD Mohamed F.K Ibrahiem
Department of Ophthalmology, Faculty of Medicine, Minia University Hospital, Minia University, 98 Korneesh El Nile Street, Minia 61111
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DJO.DJO_15_20

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Purpose The aim of this study was to detect the anatomical level of acquired lacrimal passage obstruction among adult patients with epiphora. Patients and methods In a 3-year period, 266 eyes of 223 adult patients with obstructive epiphora were evaluated clinically by probing/irrigation of the lacrimal passages to detect the anatomical level of obstruction. Patients were divided into four groups: punctal, canalicular, nasolacrimal duct (NLD), and mixed groups according to the level of obstruction. Results The age of the patients ranged from 18 to 75 years, and 83.46% of the patients were living in rural areas. Overall, 82% of the patients were females, and 78.99% of them used to apply Kohl as eyeliner cosmetic for an average of 15.62 years. Punctal disorders were detected in 14.67% of the patients, of whom 9.78% had isolated punctal disorders and 4.89% were in the mixed multiple level subgroup. Punctal obstruction represented 69% of the patients with isolated punctal disorders. Canalicular disorders represented 65.4% of all patients, where 70% had isolated canalicular disorder and 30% were in the mixed subgroup. Overall, 39% of all patients had acquired NLD obstruction; 63.5% of them had isolated NLD disorder and 36.5% had multifocal obstruction. Multifocal obstruction of the lacrimal passages was reported in 19.17% of all patients. Conclusion The main site of obstruction was the common canaliculus as two-thirds of the patients had canalicular problems. The second common site of obstruction was the NLD followed by the puncta.

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