highly significantp < 0.001
The central finding was a strong, statistically significant negative correlation between punctum size and TBUT (ρ = −0.70, p < 0.000001), corroborated by a Kruskal–Wallis test confirming highly significant inter-group differences (H = 140.1, p < 0.001) and significant pairwise separations between all three lacrimal punctal diameter categories after Bonferroni correction.