Lacrimal duct diseases are the potential cause of corneal epitheliopathy

Abstract Purpose: The purpose of this study was to determine the frequency of corneal epitheliopathy in patients with lacrimal duct diseases and to elucidate the clinical characteristics of patients with corneal epitheliopathy. Methods: Among patients diagnosed with lacrimal duct diseases comprising chronic dacryocystitis and lacrimal canaliculitis at our institution between 2015 and 2022, those who had corneal epitheliopathy were studied. Severity of corneal epitheliopathy was evaluated using the National Eye Institute/Industry (NEI) corneal grading scale. Systemic diseases, ocular diseases, and types of eye drops used were extracted from medical records. Pathogens cultured from ocular secretions in lacrimal duct or revealed by pathological examination of concretions were examined. NEI scores before and after treatment for lacrimal duct diseases were compared. Results: 161 eyes with lacrimal duct diseases consisted of 138 eyes with chronic dacryocystitis and 23 eyes with lacrimal canaliculitis. Corneal epitheliopathy was found in 13 eyes (8.1%) with lacrimal duct diseases; 11 eyes (8.0%) with chronic dacryocystitis, and 2 eyes (8.7%) with lacrimal canaliculitis. None of the patients with corneal epitheliopathy had specific systemic or ocular diseases. Six patients used antibiotic eye drops, but only one patient used corticosteroid eye drops. Pathogens were detected in the lacrimal duct in 12 of 15 eyes with corneal epitheliopathy. Corneal epitheliopathy improved in all eyes after treatment for lacrimal duct diseases. Conclusion: Lacrimal duct diseases may potentially lead to corneal epitheliopathy. In a case of refractory corneal epitheliopathy accompanied by conjunctival congestion and ocular secretions lacrimal duct disorders should be investigated and treated appropriately.