Lacrimal gland ductule stones

Chronic unilateral conjunctivitis may be caused by various infectious, inflammatory, neoplastic, or mechanical conditions. Two patients with persistent unilateral conjunctivitis were cured after removal of dacryoliths from the palpebral lobe of the ipsilateral lacrimal gland. Although lacrimal gland ductular dacryoliths are rare, this entity should be included in the differential diagnosis of chronic unilateral conjunctivitis.     

Pleomorphic adenoma in the palpebral lobe of the lacrimal gland misdiagnosed as chalazion

We reported a case of pleomorphic adenoma of the lacrimal gland involving the palpebral lobe in young teenage girl of Asian origin. The presentation at young age group is rare, which initially misdiagnosed as a large chalazion. The benign tumor with its intact pseudocapsule was removed through lateral orbitotomy together with the suspicious looking orbital lobe.     

泪腺导管囊肿的临床研究

目的 探讨泪腺导管囊肿的发病机制、临床特点、影像学特点、鉴别诊断、组织病理学特点及治疗原则.方法 回顾性分析天津市眼科医院2003～2008年15例(15只眼)经手术后病理证实的泪腺导管囊肿患者.结果 所有患者均单眼发病,多以发现眼眶颞上方结膜下囊性肿物就诊,亦可伴眼部胀痛、异物感,眼球突出及移位,上脸下垂等,部分患者主诉情绪激动后肿物增大,可无眼部炎症、外伤及手术病史.B超及CT均显示囊性占位病变,少数可伴骨质受压变形或缺损.双层细胞构成囊壁为组织学诊断要点.结论 根据泪腺导管囊肿临床特点及影像学特征可基本明确诊断,但与结膜上皮性囊肿等鉴别仍需组织病理学最终确诊.最佳治愈方法为完整切除囊肿.该病发病机制仍有待进一步讨论.     

Lacrimal gland prolapse in two cases of blepharochalasis syndrome and its treatment

Blepharochalasis is a rare disorder characterized by recurrent non-painful eyelid edema, which leads to atrophy and stretching of the supporting connective tissue around the eye. As a consequence, prolapse of the lacrimal gland can occur which results in fullness in the temporal third of the upper eyelids and may cause visual field restriction or cosmetic blemish for patients. Thus, correct diagnosis is important to plan appropriate surgery and obtain a successful postoperative result. We present two young patients with lacrimal gland prolapse associated with blepharochalasis and report on their treatment.     

Lacrimal duct obstruction in newborn infants

Presented is the personal experience concerning the early opening of the occluded lacrimal passages. In 149 newborn babies 4-5 days of age the author performed--according to indications--the syringing and probing of the lacrimal passages with a full success.     

Lacrimal gland hypertrophy: revealing sarcoidosis]

We present a case of systemic sarcoidosis in a 34-year-old woman initially presenting with bilateral and symmetric proptosis caused by lacrimal gland enlargement. Based upon clinical, biological and radiological findings, sarcoidosis was suspected with lacrymal gland, parotid and pulmonary lesions. Biopsy of enlarged lacrimal gland for histological examination revealed a non caseating granuloma compatible with the diagnosis of sarcoidosis. Sarcoid lesions regressed with corticosteroid therapy.     

Lacrimal gland abscess: two case reports

BACKGROUND: Bacterial dacryoadenitis is rare and suppuration leading to abscess formation within the lacrimal gland has been very rarely reported in the antibiotic era. METHODS: The medical records and investigation results, including computed tomography (CT), of two patients with lacrimal gland abscess were reviewed. RESULTS: Two cases of lacrimal gland abscess, one a 28-year-old male and the other a 64-year-old female, are described. Both demonstrated a characteristic low-density area within an enlarged lacrimal gland on CT. The first case had been treated with antibiotics and the abscess, when drained, was sterile. The second case settled spontaneously. Neither patient suffered any sequelae of dry eye. CONCLUSIONS: Although rare, lacrimal gland abscess may still occur and may require surgical drainage if spontaneous resolution does not occur.     

Lacrimal gland involvement in Kikuchi-Fujimoto disease

PURPOSE. A 32-year-old Saudi female presented with typical Kikuchi-Fujimoto disease, i.e., fever, cervical lymphadenitis and leukopenia, but there was also painful upper eyelid swelling with pain on upgaze. METHODS. A connective tissue disease and lymphoma workup were unremarkable, as were antibody titers to Apifia felis and Bartonella henselae. RESULTS. Orbital computed tomography showed significant lacrimal gland enlargement. Cervical node biopsy revealed necrotizing lymphadenitis. CONCLUSION. Concomitant lacrimal gland inflammation and cervical lymphadenopathy may be a benign self-limited disease.     

Lacrimal gland involvement in Kikuchi-Fujimoto disease

PURPOSE A 32-year-old Saudi female presented with typical Kikuchi-Fujimoto disease, i.e., fever, cervical lymphadenitis and leukopenia, but there was also painful upper eyelid swelling with pain on upgaze. METHODS A connective tissue disease and lymphoma workup were unremarkable, as were antibody titers to Apifia felis and Bartonella henselae . RESULTS Orbital computed tomography showed significant lacrimal gland enlargement. Cervical node biopsy revealed necrotizing lymphadenitis. CONCLUSION Concomitant lacrimal gland inflammation and cervical lymphadenopathy may be a benign self-limited disease.     

Lacrimal gland enlargement in familial sarcoidosis

Familial sarcoidosis is rare. It is unusual for lacrimal gland enlargement to be the initial manifestation of sarcoidosis. Two sisters are described with lacrimal gland enlargement as the initial manifestation of sarcoidosis. Gallium-67 scan was a useful adjunct to lacrimal biopsy in sarcoidosis. Sarcoid dacryoadenitis responded dramatically to a short term course of low dose prednisone.     

Pseudouveitis--analysis of cases misdiagnosed as posterior uveitis

PURPOSE: Analysis of non-uveitic entities that were referred as posterior uveitis to a uveitis referral center. METHODS: We came across and analyzed 32 cases of non-uveitic entities (1.12%) that had been misdiagnosed and referred as posterior uveitis out of 2846 outpatient cases of posterior uveitis registered from 1990 to June 2002. The final diagnosis was achieved by history, slit-lamp biomicroscopy, meticulous fundus evaluation, imaging, and ancillary studies. RESULTS: The finally diagnosed 32 non-uveitic entities that mimicked posterior uveitis were multiple leak central serous retinopathy (n = 8; 25%), choroidal neovascular membrane (n = 6; 18.75%), typical central serous retinopathy (n = 4; 12.5%), dry form of age-related macular degeneration (n = 3; 9.3%), retinitis pigmentosa (n = 3; 9.3%), heredomacular degeneration (n = 3; 9.3%), myelinated nerve fibers (n = 2; 6.2%), malignant melanoma of the choroid (n = 1; 3.1%), old spontaneously reattached retinal detachment (n = 1; 3.1%), and subhyaloid hemorrhage (n = 1; 3.1%). CONCLUSION: The purpose of the study was to underline the fact that there are some non-uveitic entities that mimic posterior uveitis and that an ophthalmologist can be deceived. The study highlights the problems diagnosing posterior uveitis and presents an algorithm of diagnostic approach to avoid misdiagnosis.     

Lacrimal gland autoimmunity in New Zealand mice

We studied the spleen cell-mediated as well as antibody-mediated cytotoxicity to lacrimal gland acinar cells in New Zealand mice, an excellent animal model of Sj?gren's syndrome. We found no difference in spleen cell-mediated cytotoxicity between young (3 months old) and old (6 to 12 months old) animals. With age, however, New Zealand mice developed an increasing level of serum autoantibodies to the lacrimal gland acinar cells. Such antibodies may play a role in the tissue damage of the lacrimal gland in these mice.     

Lacrimal gland involvement in graft-versus-host disease: a murine model

PURPOSE: To describe lacrimal gland involvement in a murine model of acute graft-versus-host disease (GVHD). METHODS: Histopathologic examination was performed on lacrimal glands of mice affected by GVHD at 1, 2, 4, and 6 weeks after allogeneic bone marrow transplantation (BMT). Histopathologic scoring, based on characteristic GVHD findings in human disease involved evaluation of periductal inflammation, apoptosis, ductal stasis, ductal debris, and fibrosis. CD3, CD4, CD8, CD20, and CD68 antibodies were used to stain leukocyte subsets in GVHD lacrimal gland infiltrates. Lacrimal glands from syngeneic BMT mice were used in control experiments. RESULTS: Patchy periductal inflammation and focal fibrosis were significantly elevated as early as 2 weeks after allogeneic BMT. Histopathologic scoring of lacrimal glands after allogeneic BMT was significantly different at 4 (P = 0.005) and 6 (P < 0.0001) weeks when compared with scores in syngeneic control mice. The leukocytes in lacrimal gland GVHD infiltrates were predominately CD3+ T lymphocytes, most of which were CD8+, with fewer CD4+ cells present. CONCLUSIONS: This study describes the first murine model of lacrimal gland GVHD with features that closely mimic those described in human disease and indicates that lacrimal involvement occurs in acute GVHD.     

Lacrimal gland abscesses: Case series and literature review

Acute dacryoadenitis with abscess formation has been rarely described. We describe four cases that resolved with incision and drainage. This includes a retrospective case series of four patients with radiologically confirmed lacrimal gland abscesses and a review of the reported cases in the literature. Computed tomography showed characteristic rim enhancing collections with central attenuation in all four cases. All patients presented with ptosis, upper eyelid erythema, and severe pain similar to scleritis. Injection of the conjunctiva and sclera was present in two patients, and a third patient presented with expression of purulent discharge onto the ocular surface upon palpation of the lacrimal gland. All patients were treated with intravenous antibiotics and underwent incision and drainage with subsequent improvement. All were monitored for 24 to 48 hours and discharged on oral antibiotics. There were no complications or recurrences. Lacrimal gland abscess formation is a rare complication of dacryoadenitis, and in our experience these patients respond well to incision and drainage in combination with systemic antibiotics.     

Lacrimal gland enlargement as one of the ocular manifestations of Wegener's granulomatosis

Wegener's granulomatosis is characterized by chronic, focal, necrotizing and granulomatous vasculitis. The localized form involves mainly the upper or lower respiratory tracts, or both. In the commoner generalized form, the kidneys are also affected. Literature findings suggest that ocular manifestations are a predominating sign in about 30% of cases. Ocular findings may include conjunctivitis, keratitis and sclerouveitis, pseudotumor of the orbit or proptosis. We report on a patient who showed bilateral episcleritis, keratitis, nasolacrimal duct obstruction and enlargement of the lacrimal gland. The latter finding was confirmed by CT scan.