1/20. Dacryolith formation around an eyelash retained in the lacrimal sac.A dacryolith was discovered in the lacrimal sac during a dacryocystorhinostomy for chronic dacryocystitis in which there was mucocele formation. Morphological examination confirmed the presence of an eyelash at the centre of the stone and electron microscopy demonstrated the presence of fungi (candida sp.) in a matrix which was of markedly vairable morphology. The mechanism by which a hair enters the punctum and passes along the canaliculus may be attributed to the step-like pattern of ridges on the surface of a hair. The directional nature of these ridges dictates preferential movement towards the root end of the hair and prevents movements in the opposite direction.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
2/20. nasolacrimal duct obstruction secondary to ectopic teeth.OBJECTIVE: To describe two patients with nasolacrimal duct obstruction (NLDO) caused by ectopic eruption of teeth. The literature concerning nasal and other unusual ectopic sites of tooth eruption is reviewed. DESIGN: Two interventional case reports and literature review. PARTICIPANTS: A 3-year-old girl with epiphora and recurrent dacryocystitis of the right eye. Previous medical and surgical management was unsuccessful. A 32-year-old female with a long history of right eye discomfort and epiphora. Previous examinations and workup were negative. INTERVENTION: A computed tomographic (CT) scan of the orbits and sinuses was performed in both patients. The ectopic teeth were surgically removed. MAIN OUTCOME MEASURES: Nasolacrimal system function and response to treatment at the last follow-up were recorded. RESULTS: In the first patient, CT imaging disclosed two teeth within the right inferior meatus compressing the nasolacrimal duct. In the second patient, CT revealed a large dental structure in the maxillary sinus compressing the nasolacrimal duct. Endoscopic tooth extraction and nasolacrimal duct probing in the first patient and surgical removal of the dental structure in the second patient effected complete resolution of symptoms. Both patients were symptom free at last follow-up. CONCLUSIONS: These cases suggest that ectopic eruption of teeth should be added to the differential diagnosis of NLDO. Surgical removal of the ectopic teeth compressing the nasolacrimal duct results in resolution of the lacrimal drainage obstruction.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
3/20. Stenosis of the lachrymal system in rubinstein-taybi syndrome.In this article the authors describe a case of atypical stenosis of the lachrymal excretory system in rubinstein-taybi syndrome (RTS) characterised by morphologic anomalies of the lachrymal bag and by alterations of the osseous structure of the nose. A 9-year-old girl, with typical findings of RTS, was affected by recurrent acute dacryocystitis and tearing. Ocular examination revealed bilateral reflux with mucous and purulent material flowing back after digital pressing: low and bilateral nose-lachrymal duct obstruction was the main cause of the reflux as confirmed by orifice probing, lachrymal drainage system irrigation and spiral CT examination using hydrosoluble contrast medium. The multiplanar reconstruction obtained from CT scanning shows that the right lachrymal sac has an abnormal shape ('grape-bunch' image) and that the left one has various bulgings, or swellings, in its shape. The 'grape-bunch' lachrymal bags are the most unusual features of our patient's lachrymal system and it is important to consider the difficulties that could occur during surgery because of the abnormal bag shape and because of the increased bone thickness in RTS patients. The 'grape-bunch' lachrymal sac is a truly unusual anatomical feature and, most probably, it could be distinctive of this syndrome.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
4/20. vasculitis of the lacrimal sac wall in wegener granulomatosis.A 35-year-old woman with a 4-year history of generalized wegener granulomatosis (WG) had clinically controlled disease. She was evaluated for a 6-month history of right lacrimal sac mass. On examination, a right chronic dacryocystitis and mucocele were observed. A right external dacryocystorhinostomy was performed. The surgical biopsy specimen from the lacrimal sac showed leukocytoclastic vasculitis with more aggressive damage to the small vessels in the deeper mucosa and focal microhemorrhages. The patient was free of symptoms 1 year after surgery. We believe this is the first report of generalized WG presenting features of an active vasculitis of the lacrimal sac wall on surgical biopsy specimen. We conclude that the lacrimal drainage system can be affected directly by focal WG vasculitis, suggesting that nasolacrimal duct obstruction is not always due to contiguous paranasal disease.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
5/20. Dacryoliths in a series of dacryocystorhinostomies: histologic and chemical analysis.PURPOSE: To present the clinical and intraoperative characteristics of dacryolith cases, to present their histologic and chemical analysis, and to relate the findings with the probable causes of their formation in a series of dacryocystorhinostomies performed in northern greece. methods: In a series of 242 dacryocystorhinostomies in patients with chronic dacryocystitis, dacryoliths large enough to perform an accurate chemical analysis and a light histologic examination were found in five cases. The chemical analysis was based on atomic absorption spectrophotometry and atomic emission spectrometry. RESULTS: These five cases concerned relatively young patients who presented symptoms of short duration as compared to the other dacryocystorhinostomy cases. In three of them, irregularities of the lacrimal sac wall were observed. The final postoperative results were satisfactory. The histologic examination revealed acellular amorphous organic material and limited areas with characteristics of calcium salt depositions. The chemical analysis showed mainly organic and minimal inorganic material. CONCLUSIONS: The irregularities of the lacrimal sac wall and the consequent flow disorders within the sac and the histologic and chemical analysis of the dacryoliths provide evidence for etiologic consideration.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
6/20. Spontaneous passage of a dacryolith.A patient had four episodes of recurrent dacryolith over 14 years. Each attack of acutely painful dacryocystitis was terminated by spontaneous passage of the dacryolith. Biochemical and dacryocystographic evidence help to explain the pathogenesis of the condition.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
7/20. stevens-johnson syndrome with associated nasolacrimal duct obstruction treated with dacryocystorhinostomy and Crawford silicone tube insertion.Although stevens-johnson syndrome (SJS) has long been recognized as a cause of punctal and canalicular obstruction, nasolacrimal duct obstruction secondary to SJS is rare and has not been reported in the ophthalmologic literature. keratoconjunctivitis sicca, entropion, and trichiasis are well-known complications of SJS that may require measures to supplement or preserve tears. Lacrimal drainage system obstruction may occasionally occur in the face of relatively normal tearing, resulting in clinically significant epiphora. We report two cases of SJS, one associated with epidemic keratoconjunctivitis, that led to nasolacrimal duct obstruction and canalicular obstruction or stenosis. Epiphora and, in one case, dacryocystitis, necessitated dacryocystorhinostomy and Crawford tube insertion.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
8/20. dacryocystorhinostomy in Wegener's granulomatosis.dacryocystorhinostomy was performed on two patients with Wegener's granulomatosis that had been quiescent for many years. Excellent results were attained, with elimination of dacryocystitis, complete relief from epiphora, and maintenance of a patent outflow tract. No wound necrosis occurred postoperatively, in contrast to a previous report in the literature. Our experience suggests that nasolacrimal duct obstruction in the setting of quiescent Wegener's granulomatosis can be treated safely and effectively with dacryocystorhinostomy.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
9/20. dacryocystitis following Kawasaki's disease.A 6 1/2-year-old white male child had developed bilateral dacryocystitis 1 year earlier, approximately 6 months after resolution of the acute phase of Kawasaki's disease. The patient had had no previous history of dacryostenosis or epiphora. After he failed to respond to appropriate antibiotic therapy, probing was partially successful on the right side, but complete obstruction persisted on the left side. At age 7 1/2 years, dacryocystorhinostomy was performed successfully on the left side. To our knowledge, dacryocystitis has not been reported previously following Kawasaki's disease. Other reported ocular complications of Kawasaki's disease, with the exception of a case of bilateral conjunctival scarring, have occurred in the acute phase of the disease.- - - - - - - - - - ranking = 2keywords = dacryocystitis (Clic here for more details about this article) |
10/20. Bilateral lacrimal duct cyst.Reports of lacrimal gland cysts have been rare, and mostly of small, unilateral cysts of the palpebral lobes. An unusual case of bilateral, large acquired cysts of the orbital lobe of the lacrimal glands is presented. Pathologic examination showed chronic inflammation and fibrosis of the lacrimal gland structures. We suggest that prolapse of the lacrimal glands with obstruction of the lacrimal ducts, combined with chronic dacryoadenitis, led to cyst formation.- - - - - - - - - - ranking = 0.027923462002475keywords = dacryoadenitis (Clic here for more details about this article) |
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