Primary acquired nasolacrimal duct obstruction, or PANDO, is a common adult lacrimal drainage disorder. The current treatment modality of dacryocystorhinostomy to bypass the obstructed nasolacrimal duct has excellent outcomes. However, the understanding of the disease etiopathogenesis needs to be revisited. There are not many studies that specifically assessed any hypothesis or ones that convincingly put forth the presumed or confirmed interpretations regarding the PANDO pathogenesis or the mechanisms or pathways involved therein. Histopathological evidence points to recurrent inflammation of the nasolacrimal duct, subsequent fibrosis, and the resultant obstruction. The disease etiopathogenesis is considered multifactorial. Several implicated suspects include anatomical narrowing of the bony nasolacrimal duct, vascular factors, local hormonal imbalance, microbial influence, nasal abnormalities, autonomic dysregulation, surfactants, lysosomal dysfunction, gastroesophageal reflux, tear proteins, and deranged local host defenses. The present work reviewed the literature on the etiopathogenesis of primary acquired nasolacrimal duct obstruction (PANDO) to gain insights into the present state of the understanding and the high-value translational implications of precisely decoding the disease etiology.

原发性获得性鼻泪管阻塞（PANDO）是一种常见的成人泪道引流疾病。目前采用泪囊鼻腔吻合术绕过阻塞的鼻泪管的治疗方式具有良好的效果。然而，需要重新审视对该疾病发病机制的理解。没有太多研究专门评估任何假设或令人信服地提出有关 PANDO 发病机制或其中涉及的机制或途径的假设或证实的解释的研究。组织病理学证据表明鼻泪管反复发炎、随后纤维化以及由此导致的阻塞。该疾病的发病机制被认为是多因素的。几个相关的嫌疑因素包括骨性鼻泪管的解剖学狭窄、血管因素、局部激素失衡、微生物影响、鼻腔异常、自主神经失调、表面活性剂、溶酶体功能障碍、胃食管反流、泪液蛋白和局部宿主防御紊乱。目前的工作回顾了有关原发性获得性鼻泪管阻塞（PANDO）发病机制的文献，以深入了解当前的理解状态以及精确解码疾病病因的高价值转化意义。