Investigation of the clinical features and therapeutic methods for the management of inflammatory lacrimal punctum diseases

Purpose: To establish if there are different classes of inflammatory lacrimal punctum diseases (ILPDs) and to examine the various strategies by which they can be managed therapeutically. Methods: Two hundred and fifty nine (259) patients with inflammatory punctum lacrimal disease were identified and used as subjects for this study. Each patient was carefully examined for evidence of morphology of lacrimal punctum which was confirmed mainly by lacrimal duct flushing and probing. Appropriate therapeutic managements were adopted for patients with other inflammatory conditions besides ILPD. The clinical effects of the various therapeutic strategies were documented. Results: Eighty-seven (87) patients out of the 259 (32.53 %) suffered from acute or chronic conjunctivitis while 66 patients (5.61 %) suffered from inflammatory lacrimal passage diseases. Patients with both conjunctivitis and lacrimal passage inflammation, patients with dry-eye symptoms, patients with just one of the conditions, and patients with mere evidence of superior punctalacrimalis represented 13.15, 14.19, 14.53, and 33.91 %, respectively. Mere evidence of inferior punctalacrimalis, and presence of acute inflammation were seen in 48.76 and 13.49 % of the 259 patients, respectively, while those with chronic inflammation lasting for 2.97 +/- 0.13 years, comprised 86.51 %. Antibiotic eye drops were used for acute inflammation, while chronic inflammation was treated with antibiotic eye drops, lacrimal punctum expansion, pus elimination, and punctum-sparing canaliculotomy. Both therapeutic methods produced satisfactory curative effects. Conclusion: The results show that satisfactory therapy of lacrimal punctum inflammation can be achieved if the right therapeutic agents and procedures are adopted based on clinical characteristics of the ILPD manifesting in the patient.