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Related Experiment Video

Updated: Oct 1, 2025

Nasolacrimal Lavage as a Treatment for Ocular Surface Toxic Soup Syndrome
03:40

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Published on: April 25, 2025

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Punctal Stenosis Associated with Topical Netarsudil Use.

Thomas M Meirick1, Raghu C Mudumbai1, Matthew M Zhang1

  • 1Department of Ophthalmology, University of Washington, Seattle, Washington.

Ophthalmology
|March 1, 2022
PubMed
Summary
This summary is machine-generated.

Topical netarsudil 0.02% for glaucoma treatment can cause punctal stenosis. Discontinuing netarsudil often resolves this condition, indicating it is reversible and inflammation-mediated.

Keywords:
Nasolacrimal duct obstructionNetarsudilPunctal stenosisSide effectTearing

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Area of Science:

  • Ophthalmology
  • Pharmacology

Background:

  • Glaucoma management often involves topical medications.
  • Punctal stenosis, a narrowing of the tear drainage system, can cause ocular discomfort and affect treatment efficacy.

Purpose of the Study:

  • To investigate the occurrence of punctal stenosis in patients using topical netarsudil 0.02% for glaucoma.
  • To assess the reversibility of netarsudil-induced punctal stenosis.

Main Methods:

  • A case series design was employed.
  • Patient charts were reviewed for those using topical netarsudil and diagnosed with punctal stenosis.
  • Alternative causes of punctal stenosis were excluded.

Main Results:

  • Sixteen patients developed punctal stenosis associated with netarsudil use, with a median onset of 12 months.
  • Tearing was a common symptom, and corneal verticillata was observed in 87.5% of patients.
  • Discontinuation of netarsudil led to the reversal of punctal stenosis and symptoms in 8 cases.

Conclusions:

  • Topical netarsudil 0.02% is associated with the development of reversible punctal stenosis.
  • This stenosis is likely inflammation-mediated and can cause significant symptoms.
  • Cessation of netarsudil treatment typically resolves the punctal stenosis and associated tearing.