Presumed Virus-Induced Punctal Occlusion

Purpose. To investigate viral infection as a cause of punctal stenosis in individuals without any ocular or systemic risk factors. Methods. The study group comprised patients with no known cause for punctal occlusion who underwent surgery at one medical center during a one-year period. Excised tissue was subjected to histological examination, PCR, and nested PCR testing for common viruses (adenovirus, influenza A and B, enterovirus, varicella-zoster, CMV, herpes simplex types 1 and 2, Epstein-Barr virus, and parainfluenza type 1). Results. All nine patients identified were female, 20-38 years of age. The three-snip-procedure resolved tearing in eight of them. All excised samples showed chronic mononuclear inflammation compatible with viral infection or with viral infection immune inflammatory reaction. PCR testing was negative for all the viruses examined; however, nested PCR was positive in three patients. Conclusion. This study supports the proposition that punctal occlusion in young healthy females may be due to viral infection.