Comparison of Lacrimal Scintigraphy and Fluorescein Dye Disappearance Test in Functional Blockage of Lacrimal System

PURPOSE: To compare the usefulness of fluorescein dye disappearance test (FDDT) and dacryoscintigraphy in functional lacrimal blockage. METHODS: The present study included with 24 patients (37 eyes), who were diagnosed with functional lacrimal blockage and underwent silicone tube insertion in our clinic. Compared to postoperative symptom improvement, the results of FDDT and dacryoscintigraphy were analyzed. RESULTS: Significant correlations were observed with FDDT and dacryoscintigraphy results in 29 eyes before surgery. In 33 eyes, there were post-operative symptom improvements and the sensitivity of each exam was estimated at 87.8% in FDDT and 90.9% in dacryoscintigraphy. After intubation normal findings were observed in each examination and the symptoms improved in 7 out of 8 eyes. CONCLUSIONS: Both FDDT and dacryoscintigraphy were considered sensitive and efficient methods in the diagnosis and evaluation of functional lacrimal blockage. Both methods require caution regarding misinterpretation by false negatives and may be complementary as well as increasing diagnostic accuracy.

The average index of fluorescein dye disappearance test in the young people

A study was carried out on 55 eyes of 29 volunteers aged from 21 to 47 years old in order to find out the average values of the fluorescein dye disappearance test (FDD test) in the young people - a group at high risk of canalicular lacerations. The results showed that, with 0.5% solution of fluorescein commonly used in daily practice, the average height of lacrimal streams dyed with fluorescein is 0.18 mm with standard deviation of 0.09 mm. This is the first work to define quantitatively the values of the FDD test on normal eyes. The results of the research could be basic data to evaluate outcomes of reconstructive canalicular surgery.

The Use of Goldmann Applanation Tonometer in Intraocular Pressure Measurement of Eyes Wearing Soft Contact Lenses

The purpose of the study was to evaluate a modified technique of Goldmann applanation tonometry without the use of fluorescein and anesthesia in normal eyes with soft contact lenses (SCLs) and to compare this technique with the conventional method. Fifty eyes were measured using Goldmann applanation tonometer. A mean intraocular pressure(IOP)was 17.5 +/-2.33mmHg by the conventional technique and 15.2 +/-2.35 mmHg by the modified technique. We found the IOPvalues of the modified method were consistently underestimated IOP levels by approximately 2.3 mmHg than those of the conventional method (R=0.86, p<0.05). This bias appears to be affected by the fluorescent dye, not affect-ed by the presence of SCL. Our results suggest that the measurements by the modified technique can reflect the IOP measured by conventional method with correction factor of+2 .3 mmHg. The modified technique is a very convenient and simple screening method to measure IOP in patients wearing SCLs, without need for removal or staining of lenses.

A Simple Test for Epiphora Caused by Punctal Stenosis

Punctal stenosis may be caused by several etiologies and easily treated by punctoplasty with accompanying procedures. History taking, external and slit-Iamp examinations, and diagnostic tests and imaging techniques of lacrimal system identified lacrimal system abnormalities. Occasionally satisfactory result was not gained after punctoplasty, so author introduce the simple test to aid diagnosis of punctal stenosis and to predict surgical result of punctoplasty. If the fluorescein dye disappearance test documents a dilation, additional fluorescein dye disappearance test was performed to evaluate the efficacy of punctal dilation to relieve the epiphora. This procedure will be helpful in the case of subtle punctal stenosis and evaluation of surgical result.

Conjunctivochalasis as a Cause of Epiphora and its Histopathological Findings

When examining in the patients with epiphora, it is common to evaluate only the insufficiency or obstruction of lacrimal pathway by irrigation or dacryocystography and to over look the conjunctival conditions near the punctum in most cases. Authors found marked redundancy of conjunctival tissue around the punctal area in 8 patients(12 eyes) who complained of epiphora. They have neither lacrimal pathway insufficiency and obstruction, nor facial palsy or lid laxity that can impass the lacrimal pump action, and also no anatomical anomaly of the puncta. In fluorescein dye dissappearence test of these patients, the clearance of dye was markedly delayed on the lesion site(Grade 3 to 4). Epiphora was dramatically improved after simple resection of redundant conjunctiva under surgical microscope. The Hematoxylin-Eosin and Toluidine-Blue staining of resected conjunctiva revealed infiltration of many inflammatory cells and increase of metachromatic cells in the conjunctival stroma.