Background: Along with canalicular or nasolacrimal duct blockage, punctum stenosis is one of the most common causes of epiphora. The purpose of the study was to investigate the prevalence of punctal occlusion outlining their presentation varieties and etiological factors. Methods: This cross-section observational study conducted on 50 patient suffering from epiphora. Patients were divided into two groups: single cause(N=19) and combination of causes (N=31). Every patient underwent: taking of the history, examination (examination of the eyelids, lid closure and lagophthalmos), evaluation of the punctum (by usage slit light for visibility, appearance and the occurrence of inflammation or oedema). Schirmer, I test used for ocular surface examination. Results: Occlusion was significantly higher in single cause than combination of causes while stenosis was significantly lower in single cause than combination of causes groups. Grades of stenosis were significantly different between the two groups. Schirmer test, lower tear meniscus height, and side of lesion were insignificantly different between study groups. Conclusions: Punctal stenosis was an extremely frequent finding in individuals suffering from epiphora. Age tended to augment the prevalence of punctal stenosis, and many patients accompanied by post-cataract surgery combined with blepharitis then topical anti-glaucoma eye drops with recurrent conjunctivitis were most common association with punctal stenosis patients who had combination of causes.

Background: The ocular surface has been defined as the parts of the eye that are exposed 40directly to the external environment (conjunctiva, cornea, limbus, and the overlying tear fil m). The purpose of this study was to determine the changes in the ocular surface among smokers. Methods: This study included 100 subjects from both sexes, age ≥ 18 years, current smoker (a person who has smoked more than 100 cigarettes in his lifetime and continues to do so) and all types of smoking. patients were classified into two groups: smokers (current smokers) (55 cases) and non-smokers (45 cases) who have never smoked and did not have smokers in their first-degree relatives to rule out the effect of passive smoking. All patients were subjected to, acuity of vision measurement, investigation with a slit lamp and special tests (schirmer 2 test, time required for tear breakup, lower tear meniscus height measurement and staining of the ocular surface).   Results: (Ocular Surface Disease Index) OSDI score was significantly different between non-smokers and smokers with P value 0.01. Schirmer 2 test values were significantly decreased in smokers more than non-smokers with P value <0.001. TBUT was significantly lower in smokers more than non-smokers with P value <0.001. T.M height was significantly lower in smokers more than non-smokers. Conjunctival staining was significantly higher in smokers than non-smokers with P value <0.001 and there was significant increase in punctate corneal staining in smokers than in non-smokers with P value <0.001. `1234567890-. Conclusions: Smoking influences the secretion and the tear film's stability; corneal and conjunctival staining was shown to be more prevalent in smokers. Also smoking generates symptoms of eye irritation, smokers are more prone to have dry eyes, and the degree of dry eye is greater in smokers than in non-smokers.  Additionally, the severity of symptoms of dry eyes increased with increasing the amount of smoking.