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K. Narayanan, Dé. Ah Kiné, C. Neoh, F. C. Figueiredo; Chronic Ocular Surface Disease Secondary to Lacrimal Drainage Disease. Invest. Ophthalmol. Vis. Sci. 2007;48(13):368.
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To report a series of patients with ocular surface disease (OSD) and concurrent lacrimal drainage system disease (LDSD) who had resolution of ocular surface disease after surgical treatment of the lacrimal drainage system disease.
We retrospectively reviewed the case-notes of 9 consecutive patients who were seen between November 1997 and October 2006 in the Ocular Surface Service of the Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom with ocular surface disease and were found to have obstructed lacrimal drainage system or lacrimal canaliculitis. All were treated medically and offered surgery for the lacrimal disease and eight of these patients underwent surgery.
All 9 patients had typical clinical features of unilateral OSD with punctate epitheliopathy, peripheral corneal vascularisation, and recurrent infections, and in addition 2 eyes had corneal ulcers on presentation. Features of LDSD included canaliculitis (2 eyes), lacrimal sac mucocele (4 eyes), common canalicular block (1 eye) and nasolacrimal duct block (2 eyes). Eight patients had surgery including dacryocystorhinostomy (n = 4), dacryocystectomy (n = 2), canalicular marsupialisation (n = 1) and punctoplasty (n = 1). One patient declined surgical treatment. The OSD resolved in all 8 patients following the lacrimal surgery though the visual improvement was limited in all but one due to permanent corneal scarring and associated conditions like cataract.
LDSD is one of the less common causes for chronic OSD however assessment of lacrimal drainage system is recommended in the management of cases of unilateral or bilateral chronic OSD, as surgery to treat the lacrimal disease can produce a resolution of the OSD. Early identification of these cases is important to avoid vision loss due to chronic corneal changes.
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