Evaluation and management of "functional" nasolacrimal blockage: results of a survey of the American Society of Ophthalmic Plastic and Reconstructive surgery.

A survey was mailed to members of The American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) concerning the diagnosis and management of patients with epiphora. Specifically, the respondent was asked about his or her work-up and management of an older patient with epiphora whose nasolacrimal system was patent on irrigation. Some pertinent findings were that 48 respondents did not choose the Jones test as one of the diagnostic procedures they employ. A small percentage of respondents do only a Jones test in their evaluation and believe that a dacryocystorhinostomy (DCR) is indicated with a negative Jones test. Technetium scan and dacryocystogram are used by only 13 and 10% of respondents, respectively. Forty-one percent of respondents would treat a pump "functional" block with DCR; 25% would use either Silastic tubing, lid tightening, or a combination of both. Most respondents believed that the success rate of Silastic tubing was fair, at best.