Evaluation of Asymptomatic Fellow Eyes of Patients with Unilateral Epiphora by Lacrimal Irrigation Test and Dacryoscintigraphy.

Objective: To evaluate the findings of dacryoscintigraphy (DSG) and lacrimal irrigation test (LIT) in asymptomatic fellow eyes of patients with unilateral epiphora, as well as the relationship between pathology of the lacrimal drainage system in symptomatic and asymptomatic eyes.

Methods: This study included 396 patients who were followed up for symptomatic unilateral epiphora due to nasolacrimal stenosis or obstruction between January 2022 and June 2024. Initially, LIT was performed in both eyes of all patients (both symptomatic and asymptomatic eyes) using a 2 ml lacrimal cannula. In all cases, DSG was performed as part of the routine examination.

Results: Among symptomatic eyes with unilateral epiphora, 72.2% (n = 286) had nasolacrimal duct obstruction, while 27.8% (n = 110) had nasolacrimal duct stenosis. When the asymptomatic fellow eyes of 396 eyes with unilateral epiphora were examined, DSG was normal in 247 eyes (62.4%) and abnormal in 149 eyes (37.6%). DSG abnormalities were post-sac delay in 137 eyes (34.6%) and pre-sac delay in 12 eyes (3.0%). When asymptomatic fellow eyes were analysed with LIT, 326 eyes (82.3%) had normal LIT, while only 70 eyes (17.7%) had an obstruction in LIT. Among the asymptomatic eyes, 239 (60.4%) had neither delay in DSG nor obstruction in LIT, while 87 (22.0%) had delay in DSG without obstruction in LIT. Only 8 (3.2%) of 247 eyes with no delay in the DSG had a blockage in the LIT. The concordance rate between LIT and DSG was 76.0% (301 eyes).

Conclusion: The combined use of DSG and LIT in the evaluation of asymptomatic eyes of cases with unilateral epiphora is crucial to improve diagnostic accuracy and develop a more targeted treatment approach.