Oral abstract presentation times

Purpose

Punctal stenosis (PS) is characterized with chronic inflammation and fibrosis of the punctum. Studies suggest a reciprocal relationship between PS and ocular surface diseases (OSD) such as blepharitis and dry eye disease. This study aims to assess clinical and conjunctival impression cytology (CIC) findings of OSD in patients with acquired PS and compare with healthy controls.

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Methods

PS patients with at least 3 months history of epiphora were compared to age-matched controls. Demographic data, Munk score, symptom duration, Kashkouli grade of PS, presence of punctal edema, meibomian gland disorder (MGD), blepharitis, hyperemia, tarsal follicular reaction, foamy secretion, superficial punctate keratopathy (SPK) was noted. Tear break-up time (t-BUT) and Schirmer test with anesthesia was recorded. CIC samples were collected from inferotemporal conjunctiva and graded according to Nelson grading system.

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Results

29 eyes of 17 patiens (12 females) and 20 eyes of 12 control cases (6 females) were included. Mean symptom duration was 7.3±4.9 (3-24) months. All of the PS cases had at least 1 of the clinical findings of OSD. Blepharitis, foamy secretion, hyperemia, SPK, follicular reaction and MGD gr above 2 rates were statistically significantly higher in the PS group (chi square, p<0.05). CIC samples revealed loss of Goblet cells and squamous metaplasia that was significantly higher than control cases (Mann Whitney U, p<0.05).

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Conclusion

This study reports increased rate of signs of OSD and conjunctival metaplasia in PS patients and supports the existing literature suggesting a bidirectional relationship between the two diseases. Clinicians should be diligent about diagnosing and managing OSD in patients with PS.

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Additional Authors

First name	Last name	Base Hospital / Institution
Nazlı	Türk	Health Sciences University Ankara Etlik City Hospital
Zahide Ceren	Kıymaz	Ulucanlar Eye Training and Research Hospital

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