PL EN
RESEARCH PAPER
Nasolacrimal Duct Obstruction in Epiphoric Patients in the North Indian Population
Asra Warees 1, A,D,F
,
 
Afreen Abbas 1, A,E-F
,
 
Mohd Faraz 2, A,C-D
,
 
Saqib Zameer 3, B-C
,
 
Zeeshan Akram 2, C-E
,
 
Urooj Fatima 2, B-C,E
,
 
Mudassir Alam 4, E-F
 
 
 
More details
Hide details
1
Department of Ophthalmology, J.N. Medical College, Paramedical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
 
2
Department of Radiodiagnosis, J.N. Medical College, Paramedical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
 
3
Department of Microbiology and Pathology, J.N. Medical College, Paramedical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
 
4
Department of Biological Sciences, Indian Biological Sciences and Research Institute (IBRI), Noida, India
 
 
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article
 
 
Submission date: 2025-08-17
 
 
Acceptance date: 2025-10-20
 
 
Publication date: 2026-01-15
 
 
Corresponding author
Mudassir Alam   

Department of Biological Sciences, Indian Biological Sciences and Research Institute, IBRI, Noida, India
 
 
Ophthalmology 2025;28(3):54-58
 
KEYWORDS
TOPICS
ABSTRACT
Introduction: Epiphora, or excessive tear production, is a common presenting complaint in ophthalmology and is frequently associated with acquired nasolacrimal duct obstruction. The purpose of this study is to find out the frequency (prevalence) of epiphora symptoms in patients with acquired nasolacrimal duct obstruction in a developing country, who attend tertiary eye care centres. Material and methods: Our study cross-sectionally analysed 300 patients over 19 years old with complaints of epiphora lasting at least 3 months, between January 2025 and May 2025. A basic ocular surface examination was performed using a handheld torch to assess the anterior eye. All participants underwent the ROPLAS test followed by lacrimal syringing. All data were recorded and analysed properly. Results: Sixty patients (20%) experienced unilateral epiphora, while the majority, 240 (80%), reported bilateral epiphora. 208 (69.33%) were females, and 92 (30.66%) were males, indicating a high rate of epiphora in the female population. An occasional tearing pattern was observed in 224 (74.66%) cases, and a continuous tearing pattern in 76 (25.33%) cases. The ROPLAS test showed positive results in 67 (22.33%) and negative results in 233 (77.66%), among younger people. The most common cause of epiphora was blocked tear ducts, with a p-value of <0.001. Conclusions: This study suggests that nasolacrimal duct obstruction is the main cause of epiphora. In total, 197 (65.66%) patients had lacrimal system obstruction or blockage, highlighting the high frequency of epiphora in northern India.
REFERENCES (28)
1.
Avdagic E, Phelps PO: Nasolacrimal duct obstruction as an important cause of epiphora. Disease-a-Month. 2020 Oct; 66(10): 101043.
 
2.
Serbest Ceylanoğlu K: Overview of Epiphora Referred to Oculoplastic Surgery Clinic in Adults. Beyoglu Eye J [Internet]. 2023 [cited 2025 Aug 9]; Available from: https://jag.journalagent.com/b....
 
3.
Woog JJ: The incidence of symptomatic acquired lacrimal outflow obstruction among residents of Olmsted County, Minnesota, 1976-2000 (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2007; 105: 649–666.
 
4.
Lee JM, Baek JS: Etiology of Epiphora. Korean J Ophthalmol. 2021 Oct 5; 35(5): 349–354.
 
5.
Nair JR, Syed R, Chan IYM, et al.: The forgotten lacrimal gland and lacrimal drainage apparatus: pictorial review of CT and MRI findings and differential diagnosis. BJR. 2022 Jul 1; 95(1135): 20211333.
 
6.
Maliborski A, Różycki R: Diagnostic imaging of the nasolacrimal drainage system. Part I. Radiological anatomy of lacrimal pathways. Physiology of tear secretion and tear outflow. Med Sci Monit. 2014 Apr 17; 20: 628– –638.
 
7.
Lu R, Huang R, Li K, et al.: The Influence of Benign Essential Blepharospasm on Dry Eye Disease and Ocular Inflammation. American Journal of Ophthalmology. 2014 Mar; 157(3): 591-597.e2.
 
8.
Ali MJ, Zetzsche M, Scholz M, et al.: New insights into the lacrimal pump. The Ocular Surface. 2020 Oct 1; 18(4): 689–698.
 
9.
Factors Affecting Tear Health | SpringerLink [Internet]. [cited 2025 Aug 9]. Available from: https://link.springer.com/chap....
 
10.
Paulsen FP, Schaudig U, Maune S, et al.: Loss of tear duct–associated lymphoid tissue in association with the scarring of symptomatic dacryostenosis. Ophthalmology. 2003 Jan; 110(1): 85–92.
 
11.
Makselis A, Petroska D, Kadziauskiene A, et al.: Acquired nasolacrimal duct obstruction: clinical and histological findings of 275 cases. BMC Ophthalmol. 2022 Dec; 22(1): 12.
 
12.
Katz H: Recurrent Corneal Erosions. Ophthalmology. 2010 Feb; 117(2): 402.
 
13.
Tucker N, Chow D, Stockl F, et al.: Clinically Suspected Primary Acquired Nasolacrimal Duct Obstruction. Ophthalmology. 1997 Nov; 104(11): 1882–1886.
 
14.
Luo B, Li M, Xiang N, et al.: The microbiologic spectrum of dacryocystitis. BMC Ophthalmology. 2021 Jan 11; 21(1): 29.
 
15.
Dantas RRA: Lacrimal Drainage System Obstruction. Seminars in Ophthalmology. 2010 May; 25(3): 98–103.
 
16.
Anderson NG, Wojno TH, Grossniklaus HE: Clinicopathologic Findings From Lacrimal Sac Biopsy Specimens Obtained During Dacryocystorhinostomy. Ophthalmic Plastic & Reconstructive Surgery. 2003 May; 19(3): 173.
 
17.
Bukhari A: Etiology of tearing in patients seen in an oculoplastic clinic in Saudi Arabia. Middle East Afr J Ophthalmol. 2013; 20(3): 198.
 
18.
Heindl LM, Jünemann A, Holbach LM: A Clinicopathologic Study of Nasal Mucosa in 350 Patients with External Dacryocystorhinostomy. Orbit. 2009 Jan; 28(1): 7–11.
 
19.
Jeffers J, Lucarelli K, Akella S, et al.: Lacrimal gland botulinum toxin injection for epiphora management. Orbit. 2022 Mar 4; 41(2): 150–161.
 
20.
Ulusoy MO, Kıvanç SA, Atakan M, et al.: How Important Is the Etiology in the Treatment of Epiphora? J Ophthalmol. 2016; 2016: 1438376.
 
21.
Tao JP, Vemuri S, Patel AD, et al.: Lateral Tarsoconjunctival Onlay Flap Lower Eyelid Suspension in Facial Nerve Paresis. Ophthalmic Plastic & Reconstructive Surgery. 2014 Jul; 30(4): 342–345.
 
22.
Yeatts RP, Crum B: An Unusual Complication of Nasolacrimal Duct Probing. Ophthalmic Surg Lasers Imaging. 1989 Jul; 20(7): 490–493.
 
23.
Malki SA, Al-Faky YH, Al-Rikabi AC: Bilateral subepidermal calcified nodules of the eyelid. Saudi Journal of Ophthalmology. 2011 Jan; 25(1): 81–83.
 
24.
Yakopson VS, Flanagan JC, Ahn D, et al.: Dacryocystorhinostomy: History, evolution and future directions. Saudi Journal of Ophthalmology. 2011 Jan; 25(1): 37–49.
 
25.
Gupta AK, Bansal S: Primary endoscopic dacryocystorhinostomy in children – Analysis of 18 patients. International Journal of Pediatric Otorhinolaryngology. 2006 Jul 1; 70(7): 1213–1217.
 
26.
Ben Simon GJ, Joseph J, Lee S, et al.: External versus Endoscopic Dacryocystorhinostomy for Acquired Nasolacrimal Duct Obstruction in a Tertiary Referral Center. Ophthalmology. 2005 Aug; 112(8): 1463–1468.
 
27.
Francis IC, Chan DG, Papalkar D, et al.: Videoreflective dacryomeniscometry in normal adults and in patients with functional or primary acquired nasolacrimal duct obstruction. American Journal of Ophthalmology. 2005 Mar; 139(3): 493–497.
 
28.
Rajabi MT, Shahraki K, Nozare A, et al.: External versus Endoscopic Dacryocystorhinostomy for Primary Acquired Nasolacrimal Duct Obstruction. Middle East Afr J Ophthalmol. 2022 Nov 23; 29(1): 1–6.
 
eISSN:1689-362X
ISSN:1505-2753
Journals System - logo
Scroll to top