Topical Cyclosporine-A for Management of Epiphora

Inclusion Criteria: * Adult patients of either sex * had a diagnosis of epiphora that persisted more than three months both indoors and outdoors * grade 0 punctal stenosis * did not adequately respond to artificial tears, topical corticosteroids and topical antibiotics or in whom corticosteroids were discontinued due to their side effects. Exclusion Criteria: * congenital punctal obstruction * edematous puncti * allergic conjunctivitis * history of dacryocystitis, * inflammatory systemic diseases * any previous chemotherapy treatment, and local irradiation. * other causes of epiphora, lid laxity, entropion, and ectropion * lid malposition, canalicular or nasolacrimal sac or duct obstruction * previous eyelid or lacrimal drainage surgery * untreated conjunctivitis or blepharitis