الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
E
piphora or tearing is the presence of a watering eye, which is a common complaint to be referred to oculoplastic clinics for evaluation.Its etiology is usually divided into two categories: reflex tearing and reduced tear outflow. Reflex tearing is usually secondary to dry eye, inflammation, allergy, other ocular surface disorders or primary hypersecretion of the lacrimal glands. Reduced tear outflow is due to obstruction at any portion of the nasaolacrimal drainage system, eyelid malposition or tear pump dysfunction caused by eyelid laxity. Many cases evaluated for epiphora are found to have a combination of causes.
While epiphora is a common complaint with a broad differential diagnosis, one of the least discussed etiologies of epiphora is punctal stenosis. The most common presenting symptom with punctal stenosis is tearing, yet patients may also vaguely complain of ocular discomfort.
Punctal stenosis is defined as a diameter of less than 0.3 mm or the inability to intubate the punctum with a 26 G cannula without dilation. Many factors have been involved in the pathogenesis of acquired punctal stenosis. Old age has been identified as a major determining factor. Other reported causes could be chronic blepharitis, infections involving the eyelid, longstanding treatment with several topical agents, mechanical trauma with secondary healing and iatrogenic trauma of repeated probing. It is not uncommon that a specific cause is not identified for punctal stenosis.
The aim of this study was to estimate the prevalence of punctal stenosis in patients presenting with obstructive epiphora to the Outpatient Ophthalmology Clinic at Ain Shams University Hospitals.
This descriptive cross-sectional study included 75 eyes of 51 patients. The study results showed that punctal stenosis is the most commonly encountered cause of obstructive epiphora. There was a female predominance of epiphora and punctal stenosis.
Our study results revealed that epiphora was more prevalent in the older age subgroups especially in the above 60 years old subgroup. Similarly, punctal stenosis was the most prevalent in the > 60 years old age subgroup. The current study showed that age was the most important factor for the existence of punctal stenosis. Another association of punctal stenosis with eye drops use was detected.
CONCLUSION
O
ur study results showed that punctal stenosis is the most commonly encountered cause of obstructive epiphora, with a female predominance. Moreover, increasing age was shown to be the most important factor for the existence of punctal stenosis. Another association of punctal stenosis with eye drops use (mainly with corticosteroid antibiotic combinations and antiglaucoma eye drops) was detected.