Age and gender differences in acquired nasolacrimal duct obstruction in a Saudi Arabian population

This study assesses male to female NLDO incidence as a function of age in Saudi Arabia and compares the demographics to a western population.

A retrospective review was conducted to identify patients who consecutively underwent dacryocystorhinostomy at King Khaled Eye Specialist Hospital between January 1, 2011 and April 31, 2012. Diagnosis of NLDO was confirmed by lacrimal irrigation as reported in clinical records, and patients with an identifiable cause of obstruction (i.e. trauma) were excluded. Demographic data (age and gender) were recorded.

A total of 68 patients were identified (47 females, 21 males; mean age 44.5 ± 18.5). The overall male-to-female ratio was 1:2.2; however, acquired NLDO incidence was higher in men than women (ratio 1:0.75) in the 15-24 age group. The mean age in our study (44.5 years) was significantly younger than those in the Olmsted County series (59.5 years, p < 0.001). Compared to the Olmsted County series, there was a lower incidence ratio of female patients in the 15-24 age group within our population (male-to-female, 1:0.75 vs. 1:4.5).

Our study found the mean age of patients with NLDO in a Saudi Arabian population is significantly younger than the mean age of a western population and a relatively higher incidence of NLDO in men than women under 25 years in the Saudi Arabian population. These demographic features may suggest different pathophysiologic mechanisms for the development of NLDO in the Saudi Arabian population. Whether these variations stem from genetic, environmental or other influences has yet to be established.