Nagaraju G 1, Samhitha H. R2, Kailash P. Chhabria3, Rishika H4
AIM: To evaluate the efficacy of Fluorescein Dye Disappearance Test in the Diagnosis of Lacrimal System Outflow Obstruction in comparison to Lacrimal Syringing
. SETTING AND DESIGN: Prospective Non-randomized Non-interventional Case Series of 1000 eyes of 500 patients at a Tertiary Eye Care Hospital in South India over 6 months from June 2013 to November 2013.
METHODS AND MATERIALS: Out-patient and inpatients posted for cataract surgery including those with complaints of epiphora were subjected to a Fluorescein Dye Disappearance Test (FDDT) followed by a Regurgitation on Pressure over the Lacrimal Sac Area (ROPLAS Test) and Lacrimal Syringing. The FDDT grade (Zappia and Milder Classification) and ROPLAS and lacrimal syringing results of each eye were recorded and tabulated and results compared to determine the efficacy of Fluorescein Dye Disappearance Test.
RESULTS: Mean age of the patients included in our study was 59. 6 years (SD±14.3 years). History of epiphora was present in 272 (27.2%) of 1000 eyes in our study. ROPLAS was positive in 19(7%) of the 272 eyes with epiphora. Lacrimal syringing demonstrated a patent system in 904 (90.4%) of 1000 eyes. Sensitivity and Specificity of FDDT in the detection of lacrimal outflow system obstruction in our study was calculated to be 100% and 86. 62% (p value <0.0001, Fischer Test).
KEY MESSAGE: Fluorescein Dye Disappearance Test is a simple, non-invasive highly sensitive method for evaluation of lacrimal system obstruction. Our study demonstrates a very high sensitivity indicating an abnormal FDDT is always suggestive of an outflow obstruction. Also, specificity of 86. 62% suggests that a severe anatomical obstruction of the lacrimal drainage system is highly unlikely in the presence of a normal fluorescein dye disappearance test. It can hence be used as a highly sensitive routine screening tool in the detection of a lacrimal outflow block.
