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Symptom assessment in patients with functional and primary acquired nasolacrimal duct obstruction before and after successful dacryocystorhinostomy surgery: a prospective study
  1. L M Cheung1,
  2. I C Francis1,
  3. F Stapleton2,
  4. G Wilcsek1
  1. 1
    The Ocular Plastics Unit, Department of Ophthalmology, Prince of Wales Hospital and the University of NSW, Randwick, Sydney, NSW, Australia
  2. 2
    School of Optometry and Vision Science, Institute for Eye Research and Vision CRC, University of NSW, Gate 14 Barker Street, Randwick, Sydney, NSW Australia
  1. Dr I C Francis, FASOPRS, Suite 12, Chatswood Grove, 12–14 Malvern Avenue, Chatswood 2067 NSW, Australia; iancfrancis{at}


Aim: To evaluate symptoms in patients with functional (FNLDO) and primary acquired (PANDO) nasolacrimal duct obstruction, evaluated prospectively before and after successful dacryocystorhinostomy (DCR) surgery.

Design: A questionnaire delivered by interview, pre- and postintervention.

Methods: Consecutive patients with either FNLDO or PANDO were derived from a tertiary referral clinic and private practice of two surgeons (GW and ICF). The preoperative cohort consisted of 33 FNLDO patients and 28 PANDO patients. Of these, only 31 patients elected to proceed to DCR surgery. There were 12 FLNDO patients and 19 PANDO patients in the postoperative cohorts, all with definitive surgical success. Successful DCR surgery was indicated by positive endoscopic Jones 1 testing. Symptoms in relation to the patient’s vision, reading, driving, mood, work and embarrassment were assessed. The severity of these symptoms was also graded.

Results: Vision and reading in particular were affected in both preoperative cohorts, and patients suffered significantly from embarrassment. Of the postoperative cohorts, the FNLDO cohort had a reduced percentage of patients suffering each symptom type, whereas the PANDO group had a reduction in percentage of patients reporting each symptom in some but not all areas. However, the overall severity was reduced in both groups, and embarrassment was significantly reduced in both groups.

Conclusion: In both FNLDO and PANDO populations, symptoms bother patients significantly, and successful DCR surgery has a positive effect on the patient’s physical and psychological well-being.

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  • Presented in part at the British and European OculoPlastics Surgery Society Meeting, London, September 2006.

  • Competing interests: None declared.

  • Abbreviations:



    fluorescein dye disappearance test


    functional nasolacrimal duct obstruction


    nasolacrimal duct obstruction


    primary acquired nasolacrimal duct obstruction

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