Idiopathic acquired lacrimal drainage obstruction

Abstract

Information concerning the pattern and incidence of idiopathic acquired lacrimal drainage obstruction has been derived from a diagnostic investigation of a pool sample of 380 cases, and is related to data previously published (Dalgleish, 1964) concerning the overall incidence of all types of idiopathic acquired lacrimal drainage obstruction. Females with naso-lacrimal duct obstruction had a significantly higher incidence of a history of dacryocystitis than males (P < 0.05). There is a very significantly higher incidence of a history of dacryocystitis in cases of combined obstruction (a combination of canaliculus and naso-lacrimal obstructions on the same side) than in cases of naso-lacrimal duct obstruction (P < 0 001). It is suggested that the canaliculus obstruction in cases of combined obstruction is usually secondary to dacryocystitis, and that dacryocystitis (as defined for the purpose of this investigation) is usually secondary to naso-lacrimal duct obstruction. The aetiology of the vast majority of cases of canaliculus obstruction is obscure and these cases must still be termed "simple" or " idiopathic" in type. Apart from the canaliculus obstruction of combined obstruction cases, a few canaliculus obstructions are probably the result of non-specific inflammation. Attention is drawn to the very significantly high incidence of bilateral similarity in cases of bilateral lacrimal drainage obstruction (P < 0 001), which suggests different aetiological factors are responsible for the two main types of idiopathic acquired lacrimal drainage obstruction.