to investigate the clinical outcomes and tolerances of Cyclosporine A (CsA) in treating epiphora in eyes with acquired punctum stenosis

a prospective study included patients who were referred to our outpatient clinics in Farwanyia hospital, Kuwait during the period between July 2019 and January 2020, having symptomatic epiphora associated with severe acquired lower punctal stenosis. Patients were treated with topical 0.05% CsA on twice daily dose with topical preservative free artificial tears Q.I. D. Patients were followed up monthly for at least 3 months by epiphora grading, Fluorescein dye disappearance test (FDT) and evaluating the patient satisfaction

Inclusion Criteria:

• Adult patients of either sex
• had a diagnosis of epiphora that persisted more than three months both indoors and outdoors
• grade 0 punctal stenosis
• did not adequately respond to artificial tears, topical corticosteroids and topical antibiotics or in whom corticosteroids were discontinued due to their side effects.

Exclusion Criteria:

• congenital punctal obstruction
• edematous puncti
• allergic conjunctivitis
• history of dacryocystitis,
• inflammatory systemic diseases
• any previous chemotherapy treatment, and local irradiation.
• other causes of epiphora, lid laxity, entropion, and ectropion
• lid malposition, canalicular or nasolacrimal sac or duct obstruction
• previous eyelid or lacrimal drainage surgery
• untreated conjunctivitis or blepharitis