title: Videoreflective dacryomeniscometry in normal adults and in patients with functional or primary acquired nasolacrimal duct obstruction.
abstract: OBJECTIVE
  Videoreflective dacryomeniscometry (VRD) for evaluation of marginal tear film has not been performed in patients with watery eye or in a controlled study. We used VRD to evaluate the height of the central marginal lower lid tear film in normal adults and compared it with two watery-eye groups and a postoperative dacryocystorhinostomy (DCR) group.
  
  
  METHODS
  Case-controlled interventional case series.
  
  
  METHODS
  We evaluated with VRD 20 subjects with normal lacrimal drainage function, 21 patients with primary acquired nasolacrimal duct obstruction (PANDO), 28 patients with functional nasolacrimal duct obstruction (FNLDO), and a postoperative group of 14 patients derived from the previous two pathologic groups. Comparison between the four groups was performed to determine statistically significant differences between tear film height.
  
  
  RESULTS
  PANDO and FNLDO groups were shown to have significantly greater median tear meniscus heights ([TMH] PANDO: 620 microm, interquartile range [IQR] 453 microm; FNLDO: 731 microm, IQR 529 microm) than normal subjects (296 microm, IQR 214 microm; P < .001) and postoperative PANDO patients (265 microm, IQR 159 microm). There was no significant difference in TMH between PANDO and FNLDO groups preoperatively (P = .275). There was a reduction in median TMH postoperatively of 355 microm (P = .008) in PANDO and 360 microm (P = .068) in FNLDO.
  
  
  CONCLUSIONS
  PANDO and FNLDO patients have similar preoperative TMH. In both these groups, TMH is significantly greater than in normal control subjects. Lacrimal drainage surgery substantially reduces TMH as measured using VRD in PANDO.
authors.affiliation: Ocular Plastics Unit, Prince of Wales Hospital, Randwick, Australia. if@student.unsw.edu.au
authors.forename: Ian C
authors.initials: IC
authors.lastname: Francis
authors.forename: Derek G
authors.initials: DG
authors.lastname: Chan
authors.forename: Daya
authors.initials: D
authors.lastname: Papalkar
authors.forename: Eric B
authors.initials: EB
authors.lastname: Papas
authors.forename: Fiona
authors.initials: F
authors.lastname: Stapleton
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003608:Dacryocystorhinostomy; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D009301:Nasolacrimal Duct / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D010781:Photography; D013666:Tears / Q000502:physiology*; D014741:Video Recording