Secondary Acquired Lacrimal Drainage Obstruction (SALDO)

Abstract

Secondary acquired lacrimal duct obstructions or SALDO is a term used to define all the secondary causes of lacrimal obstructions [1–4]. It essentially means that the specific cause of obstructions could be zeroed in on, and therapies targeting the cause may result in relief from obstructions. Bartley GB et al. [1–4] described five categories of secondary obstructions, namely, infectious, inflammatory, traumatic, mechanical, and neoplastic with numerous etiologies for each category. Most of the traumatic and neoplastic etiologies have been covered under specific chapters in this Atlas. Inflammatory SALDO can include endogenous etiologies like Stevens-Johnson syndrome, cicatricial pemphigoid, sarcoidosis, and Wegener’s granulomatosis. Exogenous etiologies include burns, allergies, use of eye drops like antiviral, radiotherapy, and certain chemotherapeutic agents like 5-fluorouracil, paclitaxel, and radioactive iodine (I-131) [4–5]. The term mechanical refers to a lacrimal passage physically obstructed anywhere along its entire course by specific agents. These could be endogenous factors like dacryoliths and migrated punctal plugs or exogenous factors like conjunctivochalasis, sinus mucocele, or caruncular masses. The general principle of treatment for a SALDO is to remove the causative factor or to minimize its influence.