Idiopathic edematous punctal stenosis with chronic epiphora: preponderance in young women

Int Ophthalmol. 2019 Sep;39(9):1981-1986. doi: 10.1007/s10792-018-1031-y. Epub 2018 Sep 29.

Abstract

Purpose: To describe a previously unreported phenomenon of idiopathic edematous punctal stenosis (IEPS) with chronic epiphora, presenting almost exclusively in young female patients.

Methods: A review of patients who presented with chronic epiphora and edematous punctal stenosis of unknown cause (IEPS) at the outpatient clinic of Soroka Medical Center between August 2011 and August 2015. Associated findings from clinical examination were recorded.

Results: A total of 32 patients with IEPS were documented. There were 30 female and 2 male patients. Average age at diagnosis was 37.6 ± 13.4 years, range 19-63 years, median 35 years. Temporary alleviation of symptoms was reported in subjects treated with topical steroids (43.8%), tacrolimus ointment (15.6%), and matrix metalloproteinase inhibitors (3.1%). No improvement in symptoms was reported in 37.5% of patients. Symptoms were bilateral in 78.1% of the patients. Spontaneous resolution was achieved in only 6.3% (2/32).

Conclusions: IEPS accompanied by chronic epiphora has not been characterized to date. Our data show a clear predominance of females, most of them in their fertile years.

Keywords: Edema; Epiphora; Inflammation; Punctum; Women.

MeSH terms

  • Administration, Topical
  • Adult
  • Anti-Inflammatory Agents / administration & dosage
  • Chronic Disease
  • Edema / diagnosis
  • Edema / drug therapy
  • Edema / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Lacrimal Apparatus / diagnostic imaging*
  • Lacrimal Apparatus Diseases / complications*
  • Lacrimal Apparatus Diseases / diagnosis
  • Lacrimal Apparatus Diseases / drug therapy
  • Lacrimal Duct Obstruction / diagnosis
  • Lacrimal Duct Obstruction / drug therapy
  • Lacrimal Duct Obstruction / etiology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Slit Lamp Microscopy
  • Young Adult

Substances

  • Anti-Inflammatory Agents