Dacryology is a science that deals with the lacrimal system of the human body. The first mention of lacrimal system dates back to the Code of Hammurabi (2250 BC) which described an incision for the infected lacrimal sac. Subsequently, the ancient Egyptian classic, Ebers Papyrus (1500 BC) details the measures to treat lacrimal sac infections. Inspite of the issues being recognized so early on along with tremendous advancements over centuries, we yet do not have definitive answers for some of the very basic questions. For example; what is the root cause of any lacrimal duct obstruction? What pathways trigger an obstruction? Why do these disorders have a gender predilection? And on and on it can go!
The great, Sir Winston Churchill once said “No problem can withstand the assault of sustained thinking”. This is where I believe we were and we are collectively lacking. There is a need for lacrimal surgeons across the globe to join hands, collaborate on much focused methodologies to deal with specific questions. Let’s exemplify it using primary acquired nasolacrimal duct obstructions (PANDO). To ascertain its etiopathogenesis, there is a need to divide the disorder to conquer it! One focused collaborative group can look at lacrimal drainage associated lymphoid tissue up to the molecular pathways and so on multiple groups can take one issue to solve at a time (lectin mediated inflammation, genetic predispositions, hormonal receptors and their mediators, tear cytokine analysis).
In these contexts, there is a great need of raising and nurturing “Clinician-Scientists”, who are well trained in both the clinical Dacryology and the basic science techniques pertaining to it. This breed of so called “MD-PhD” goes a long way in contributing to translational medicine. They can not only very well understand the clinical problems, but also take them to the laboratory themselves, collaborate and take the solutions back to the clinics. Dacryology is too serious a job to be left to one group alone!
There are multiple places across the globe where Dacryology is being increasingly given attention. I am glad that India is leading this initiative both in clinical and basic sciences. For example, the recent inauguration of “Govindram Seksaria Institute of Dacryology at the L.V.Prasad Eye Institute would hopefully pave a way for global collaborations and raising, training and supporting a generation of focused “Clinicians-Scientists” armed to take on the multiple challenges of lacrimal disorders”. There is a need for Dacryologists globally to set audacious goals and strive hard to achieve them so that we can make difference to the present and the future!