Prevalence of punctal stenosis among ophthalmology patients

Abstract

Purpose:To estimate the prevalence of punctal stenosis among patients visiting the general ophthalmology clinic for routine checkup.Design:Prospective, observational case series.Materials and Methods:A total of 682 patients were evaluated for evidence of punctal stenosis from May to November 2008. Any associated findings from clinical examination were recorded.Results:As many as 54.3% (370/682) of the candidates had punctal stenosis. The prevalence is associated significantly with increasing age (p=.001), and no gender predilection was found. It was due to chronic blepharitis in 97% (359/370), entropion in 1.4% (5/370) and unknown causes in 1.6% (6/370) of the patients. As many as 58.1% (215/370) did not have subjective or objective evidence of epiphora, and all of them had a tear film breakup time of less than 10 seconds and positive corneal fluorescein staining.Conclusion:Punctal stenosis is a common finding among patients presenting for routine eye checkup. It increases with advancing age, and the most common predisposing factor is chronic blepharitis. A significant number of patients can be asymptomatic as they have concurrent dry eye disease. Surgical intervention is not recommended unless the patient is symptomatic after treating any associated blepharitis and dry eye disease.

Prevalence and Associations of External Punctal Stenosis in a General Population in Spain

“…13,14 Studies performed in clinical settings report conflicting results ranging from 8% in a study among patients with epiphora to 54.3% in a study performed in a general ophthalmology outpatient clinic. 3,4 The striking differences in prevalence estimates shown in these investigations may be explained by several factors among which sampling procedures and diagnostic criteria are probably some of the most important. To minimize selection bias and reduce the possibility of misdiagnoses, we used a population-based approach and checked punctal morphology and size because considerable differences in punctal orifice size have been described among normal individuals.…”

“…The frequency of EPS in clinical practice is high, 3,4 and case series and a few hospital-based studies have linked several factors including infections, inflammations, lid malpositions, and certain medications to this condition. [5][6][7][8][9][10][11] However, the prevalence and associations of this disorder in the general population are largely unknown because no population-based studies to our knowledge have been conducted so far.…”

Epiphora after Uncomplicated Phacoemulsification: Study of Prevalence and Associated Factors

“…6 Furthermore, Bukhari reported in 2009 that the prevalence of unctual stenosis among patients who visit an ophthalmologist for routine screening was 54.3%, out of which 97% presented with associated chronic blepharitis. 7 We postulate that these patients may have a limited ability to evacuate the tear, which could lead to a transient failure of tear drainage after an invasive procedure, such as cataract surgery represents. In our opinion, the existence of a proinflammatory tear related to a lacrimal dysfunction syndrome could cause a chronic inflammation of the ductal epithelium with subsequent scarring and stenosis.…”

Etiology of tearing in patients seen in an oculoplastic clinic in Saudi Arabia

“…This can be explained by the fact that among the Saudi population there is a 54.3% prevalence of punctal stenosis2 related mainly to chronic lid margin irritation and inflammation caused by chronic blepharitis, a disease that is very prevalent in the Saudi population 34…”