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External punctal stenosis linked to degenerative disorders, outdoor occupation
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External punctal stenosis was found to be highly prevalent in an adult population in northwestern Spain, according to a study.
“An association was found with processes associated with degeneration such as normal aging or pinguecula but not with processes associated with inflammation such as dry eye or blepharitis,” the study authors said. “Further population-based and basic analyses are needed to evaluate the relationship with these processes. Measures directed at reducing the impact of modifiable factors such as sun exposure should be recommended.”
Data were culled from the Salnés Eye Study, a population-based epidemiological analysis that included adults older than 40 years living in O Salnés, a maritime area of northwestern Spain.
The cross-sectional study included 621 subjects with a mean age of 63.4 years.
Subjects underwent comprehensive ophthalmic examinations and completed a questionnaire on systemic disease history and lifestyle factors. Investigators recorded cases of external punctal stenosis and calculated weighted associations with demographic, systemic and lifestyle variables.
Study results showed that the overall prevalence of external punctal stenosis was 17.3%: 13.8% in men and 19.4% in women. The prevalence increased significantly with age (P = .000).
Age- and gender-adjusted data showed a strong correlation between external punctal stenosis and outdoor occupation and the presence of degenerative conditions such as pinguecula. However, external punctal stenosis did not correlate with inflammatory disorders such as blepharitis or dry eye syndrome, the authors said.
Perspective
Back to TopDavid R. Hardten, MD
This interesting study shows a very high incidence (17.3%) of external punctal stenosis in a group of patients from Spain. I wanted to see what the incidence was in my Minnesota patient population, so today I looked for this in all of my patients. Out of 37 patients seen at the slit lamp today, two had punctal stenosis, although one had previously undergone cautery punctal occlusion, and the other had cicatricial ocular pemphigoid. I would have expected six patients to have this if the incidence in my clinic population was the same as they had in their study. So, at least in my patient population, it seems relatively low. Still, it is something to be on the look-out for, especially in patients who may have ocular surface disease symptoms.
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