Primary Acquired Nasolacrimal Duct Obstruction (PANDO) and Secondary Acquired Lacrimal Duct Obstructions (SALDO)

  • Saurabh Kamal
  • Mohammad Javed Ali


Epiphora resulting from nasolacrimal duct obstruction (NLDO) is common and accounts for about one-third of cases [1]. Symptomatic acquired NLDO has an average annual incidence rate of 30.47 per 100,000 [2]. It is commonly encountered in ophthalmic clinics especially ophthalmic plastics and dacryology clinics. NLDO can be classified as either primary acquired nasolacrimal duct obstruction (PANDO) when it is idiopathic or secondary acquired lacrimal duct obstructions (SALDO) when it is secondary to various etiologies [3, 4]. The term PANDO was given by Linberg and McCormick in 1986 [4]. They described a female preponderance, a usual onset of epiphora after the age of 40 years, subsequent development of associated symptoms, and signs of chronic or acute dacryocystitis, which constitute the clinical syndrome of primary acquired nasolacrimal duct obstruction (PANDO) [4].


Allergic Conjunctivitis Nasolacrimal Duct Timolol Maleate Orbital Cellulitis Cavernous Sinus Thrombosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Sibley D, Norris JH, Malhotra R. Management and outcomes of patients with epiphora referred to a specialist ophthalmic plastic unit. Clin Experiment Ophthalmol. 2013;41:231–8.PubMedGoogle Scholar
  2. 2.
    Woog JJ. The incidence of symptomatic acquired lacrimal outflow obstruction among residents of Olmsted County, Minnesota, 1976–2000 (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2007;105:649–66.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Bartley GB. Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature. Part 1. Ophthal Plast Reconstr Surg. 1992;8:237–42.PubMedCrossRefGoogle Scholar
  4. 4.
    Linberg JV, McCormick SA. Primary acquired nasolacrimal duct obstruction. A clinicopathologic report and biopsy technique. Ophthalmology. 1986;93:1055–63.PubMedCrossRefGoogle Scholar
  5. 5.
    Paulsen FP, Thale AB, Hallmann UJ, et al. The cavernous body of the human efferent tear ducts: function in tear outflow mechanism. Invest Ophthalmol Vis Sci. 2000;41:965–70.PubMedGoogle Scholar
  6. 6.
    Paulsen FP, Thale AB, Maune S, et al. New insights into the pathophysiology of primary acquired dacryostenosis. Ophthalmology. 2001;108:2329–36.PubMedCrossRefGoogle Scholar
  7. 7.
    Perra MT, Serra A, Sirigu P, et al. A histochemical and immunohistochemical study of certain defence mechanisms in the human lacrimal sac epithelium. Arch Histol Cytol. 1995;58:517–22.PubMedCrossRefGoogle Scholar
  8. 8.
    Blicker JA, Buffam FV. Lacrimal sac, conjunctival, and nasal culture results in dacryocystorhinostomy patients. Ophthal Plast Reconstr Surg. 1993;9:43–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Ali MJ, Mulay K, Pujari A, et al. Derangements of lacrimal drainage-associated lymphoid tissue (LDALT) in human chronic dacryocystitis. Ocul Immunol Inflamm. 2013;21:417–23.PubMedCrossRefGoogle Scholar
  10. 10.
    Paulsen FP, Schaudig U, Maune S, et al. Loss of tear duct-associated lymphoid tissue in association with the scarring of symptomatic dacryostenosis. Ophthalmology. 2003;110:85–92.PubMedCrossRefGoogle Scholar
  11. 11.
    Janssen AG, Mansour K, Bos JJ, et al. Diameter of the bony lacrimal canal: normal values and values related to nasolacrimal duct obstruction: assessment with CT. AJNR Am J Neuroradiol. 2001;22:845–50.PubMedGoogle Scholar
  12. 12.
    Shigeta K, Takegoshi H, Kikuchi S. Sex and age differences in the bony nasolacrimal canal: anatomical study. Arch Ophthalmol. 2007;125:1677–81.PubMedCrossRefGoogle Scholar
  13. 13.
    Ohtomo K, Ueta T, Toyama T, et al. Predisposing factors for primary acquired nasolacrimal duct obstruction. Graefes Arch Clin Exp Ophthalmol. 2013;251:1835–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Nemet AY, Vinker S. Associated morbidity of nasolacrimal duct obstruction-a large community based case-control study. Graefes Arch Clin Exp Ophthalmol. 2014;252:125–30.PubMedCrossRefGoogle Scholar
  15. 15.
    Owji N, Bagher Abtahi SM. Does gastroesophageal reflux contribute to development of acquired nasolacrimal duct obstruction? Med Hypotheses. 2010;74:455–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Duke-Elder WS. Diseases of lacrimal passages. In: Text book of ophthalmology. St. Louis: C.V. Mosby; 1952. p. 5279–366.Google Scholar
  17. 17.
    Perry LJ, Jakobiec FA, Zakka FR, et al. Giant dacryocystomucopyocele in an adult: a review of lacrimal sac enlargements with clinical and histopathologic differential diagnoses. Surv Ophthalmol. 2012;57:474–85.PubMedCrossRefGoogle Scholar
  18. 18.
    Ali MJ, Joshi SD, Naik MN, et al. Clinical profile and management outcome of acute dacryocystitis: two decades of experience in tertiary eye care centre. Semin Ophthalmol. 2013.Google Scholar
  19. 19.
    Ali MJ, Motukupally SR, Joshi SD, et al. The microbiological profile of lacrimal abscess: two decades of experience from a tertiary eye care center. J Ophthalmic Inflamm Infect. 2013;3:57–61.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Jutley G, Karim R, Joharatnam N, et al. Patient satisfaction following endoscopic endonasal dacryocystorhinostomy: a quality of life study. Eye. 2013;27:1084–9.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Bartley GB. Acquired lacrimal drainage obstruction: an etiologic classification system, case reports and a review of literature. Part 2. Ophthal Plast Reconstr Surg. 1992;8:243–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Bartley GB. Acquired lacrimal drainage obstruction: an etiologic classification system, case reports and a review of literature. Part 3. Ophthal Plast Reconstr Surg. 1993;9:11–26.PubMedCrossRefGoogle Scholar
  23. 23.
    Ali MJ, Gupta H, Honavar SG, et al. Acquired nasolacrimal duct obstructions secondary to naso-orbito-ethmoidal fractures: patterns and outcomes. Ophthal Plast Reconstr Surg. 2012;28:242–5.PubMedCrossRefGoogle Scholar

Copyright information

© Springer India 2015

Authors and Affiliations

  1. 1.Ophthalmic Plastics SurgeryL.V. Prasad Eye InstituteHyderabadIndia
  2. 2.Dacryology ServiceL.V. Prasad Eye InstituteBanjara Hills, HyderabadIndia

Personalised recommendations