Kyeong J, et al. - In patients with punctal stenosis, researchers conducted this retrospective review to study the etiology of punctal stenosis based on the histopathological characteristics of puncta and clinical associations. The sample consisted of 69 cases from 38 individuals who were diagnosed with punctal stenosis. For the evaluation of punctal occlusions, slit-lamp examination, the lacrimal irrigation test, dacryocystography, and spectral domain-optical coherence tomography have been performed. The pathological characteristics of the punctal membranes were classified into two types of epithelia: squamous and columnar. According to results, subepithelial fibrosis was the most common pathological feature in patients with stenosis with squamous epithelium, while inflammation was more closely correlated with columnar epithelium patients. However, no link was found between the histopathological findings and treatment outcomes. The histopathological findings indicate that primary stenotic punctum fibrosis was caused by intrinsic punctum inflammation instead of spreading from the conjunctiva or eyelid. Punctoplasty, regardless of the epithelial type, was successful in the treatment of punctal stenosis.