Stenosed Punctum OCTs
Research type
Research Study
Full title
Characterisation of the Healthy and Stenosed Lacrimal Punctum using Spectral Domain Optical Coherence Tomography: An Exploratory Prospective Case Series
IRAS ID
153332
Contact name
Daniel Ezra
Contact email
Sponsor organisation
Moorfields Eye Hospital NHS Foundation Trust
Research summary
The lacrimal puntum is the anatomical site through which tears drain away from the surface of the eye. The punctum then opens into the cannaliculus, a long tube which connects to the lacrimal sac, usually via a common cannaliculus. There are four puncti in total, found at the medial end of each eyelid. A watery eye is a common patient complaint and can often be a consequence of punctual disease such as narrowing, stenosis or atresia. Patients with narrowed puncti are offered surgical punctoplasty where it is enlarged posteriorly. However, this does not improve the symptoms in all patients and it can be difficult to predict which patients will benefit.
Primary Objective: To use OCT to look for characteristics of small puncti in patients with watery eyes and identify characteristics which can predict a reduction in watering from surgical punctoplasty.
Secondary Objective: To have a better understanding of the morphology of the lacrimal punctum.
All normal volunteers and patients will have an anterior segment OCT performed which is a safe, pain free imaging method with no side effects. The decision by the clinic doctor to offer surgical punctoplasty will not be affected by the trial and will be as per normal standard care.
OCT images will be analysed for qualitative and quantitative characteristics - external diameter of punctal opening, internal diameter of punctal opening, presence of fluid level/levels. Patients will be asked to score their watery eye before and 1 month after surgical punctoplasty using the Munk scoring system
0 = no epiphora
1 = occational epiphora requiring dabbing less than twice a day
2 = dabbing two to four times a day
3 = epiphora requiring dabbing five to ten times a day
4 = epiphora requiring dabbing more than ten times a day
Methods:
1. 20 Healthy Volunteers will be recruited from Staff and will have anterior segment OCT of their lower puncti. No patient identifiable data will be recorded. We will record their age and ethnicity.
2. 20 patients in the lacrimal clinic will be recruited. These will be patients who complain of a watery eye and have been fully assessed by the clinic doctor, been offered and wish to have punctoplasty on one or both lower puncti.
3. The 20 patients will be given an information leaflet and consented to be part of the study
4. The patients will have OCT of their lower puncti.
5. The patients will be asked to grade their watery eye.
6. The patients will be phoned 1 month after their punctoplasty to grade their watery eye.REC name
London - Westminster Research Ethics Committee
REC reference
14/LO/1450
Date of REC Opinion
12 Sep 2014
REC opinion
Further Information Favourable Opinion