Acquired external punctal tenoi: etiology and aociated finding

Purpoe To invetigate the underlying caue of acquired external punctal tenoi (AEP) and ae the aociated tear drainage problem. Deign Propective, noncomparative obervational cae erie. Method eventy-eight eye of 52 patient with ymptomatic AEP were propectively aeed by or under uperviion of a conultant oculoplatic urgeon from June 1999 to October 2002. The everity of the tenoi wa graded on clinical examination. Aociated finding from ophthalmic examination, diagnotic probing, and irrigation were recorded. The χ2 tet with 95% confidence interval (CI) and the Fiher exact tet were ued for tatitical analyi. Reult The age range wa 39 to 90 year (mean, 69.4 year). Acquired external punctal tenoi wa due to chronic blephariti in 35 eye (45%), unknown etiology in 21 eye (27%), ectropion in 18 eye (23%), and related to drug in 4 eye (5%). Aociated canalicular tenoi and common canalicular tenoi with obtruction (at the level of the internal punctum) wa found in 36 eye (46%) with AEP. Naolacrimal duct tenoi (5 eye) or obtruction (2 eye) wa found in 8.5%. The number of patient with aociated canalicular and common canalicular tenoi increaed with increaing age (95% Confidence Interval [CI] = 0.03–0.04, P = .03) and duration of ymptom (95% CI = 0.02–0.03, P = .02). The number of patient with aociated naolacrimal duct tenoi and obtruction increaed with increaing age (95% CI = 0.000– 0.001, P = .001) and in AEP with unknown etiology (95% CI = 0.004–0.006, P = .003). Concluion Chronic blephariti i a common caue of AEP even after treating the blephariti, but in a ignificant number of patient there i no apparent etiology. Aociated upper and lower tear drainage tenoi hould be conidered in the preoperative evaluation and urgical plan for AEP.