Clinical Evaluation of Lacrimal Gland Ductal Disease

Seon Ae Shin; Chang Wook Choi; Sang Duck Kim

doi:10.3341/jkos.2014.55.1.7

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Shin, Choi, and Kim: Clinical Evaluation of Lacrimal Gland Ductal Disease

Original Article

J Korean Ophthalmol Soc 2014;55(1):7-12.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.1.7

Clinical Evaluation of Lacrimal Gland Ductal Disease

Seon Ae Shin, MD, Chang Wook Choi, MD, Sang Duck Kim, MD, PhD

Department of Ophthalmology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan Korea

Address reprint requests to Sang Duck Kim, MD, PhD Department of Ophthalmology, Wonkwang University Hospital, #895 Muwang-ro, Iksan 570-711, Korea, Tel: 82-63-859-1370, Fax: 82-63-855-1801, E-mail: sangduck@wonkwang.ac.kr

Received 16 August 201328 August 2013 Accepted 20 November 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the clinical characteristics and management of lacrimal gland ductal disease, a rare disease often mistaken for other diseases.

Methods

A retrospective chart review of 11 patients (11 eyes, 5 males, 6 females) diagnosed with lacrimal ductal disease between March 2007 and April 2013 was performed.

Results

Among 11 eyes in 11 patients, 4 were diagnosed with dacryops and 7 with lacrimal gland ductulitis initiated by dacryolith. The mean age of the subjects was 47.9 years (range, 30-80 years). Lacrimal gland ductulitis patients received treatment for conjunctivitis or hordeolum for several months. Four cases involved the right eye and 7 cases involved the left eye. Symptoms included foreign body sensation, pus-like discharge and palpable mass. Biopsy was performed in 3 cases and showed no specific findings. Patients with dacryops underwent marsupialization, whereas patients diagnosed with lacrimal gland ductulitis underwent excision and dacryolith curettage. During the 2-month follow-up period, all cases showed no signs of recurrence or complications.

Conclusions

Lacrimal gland ductal disease can be mistaken for other diseases such as conjunctivitis, hordeolum, or orbital cyst, thus requiring accurate diagnosis and appropriate management.

Keywords: Dacryolith, Dacryops, Lacrimal gland ductulitis, Marsupialization

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Figure 1.

Post-operative photograph of marsupialization of right dacryops of 38-year-old man. The cyst walls marsu-pialized and the edges of the cyst lining were coapted to the edges of conjunctiva with 8-0 vicryl sutures.

Figure 2.

(A) Pre-operative photograph of dacryops of left lacrimal gland of 66-year-old female presenting with cystic mass at the left superotemporal conjunctival cul-de-sac. (B) Post-oper-ative (3 days after marsupialization) photograph. (C) Post-oper-ative (1 month after marsupialization) photograph.

Figure 3.

(A) Pre-operative photograph of a cystic mass with concretions at the left lateral canthal angle illustrated in 30-year-old female. (B) Macroscopic view of dacryolith and hair removed from the lacrimal gland ductule during the operation. (C) Post-operative (1 month after excision and dacryolith curettage) photograph.

Table 1.

Summary of management of 11 cases of lacrimal gland ductal disease

No	Age (years)/Sex	Signs & Symptoms	Duration (months)	Diagnosis	Treatment
1	35/M	Right upper lid mass	1	Dacryops	Marsupialization & biopsy
2	36/M	Left upper lid mass	2	Lacrimal gland ductulitis	Excision & dacryolith curettage & biopsy
3	31/F	Right upper outer lid mass with foreign body sensation	2	Lacrimal gland ductulitis	Excision & dacryolith curettage
4	55/M	Left eyelid swelling with pus like discharge	3	Lacrimal gland ductulitis	Excision & dacryolith curettage
5	66/F	Left mass of lateral canthus	1	Dacryops	Marsupialization & biopsy
6	30/F	Left eye discharge, some tearing	1	Lacrimal gland ductulitis	Excision & dacryolith curettage
7	72/M	Left eye foreign body sensation	1	Dacryops	Observation
8	51/F	Left eyewax, itching sensation	3	Lacrimal gland ductulitis	Excision & dacryolith curettage
9	34/F	Left eye foreign body sensation, tenderness	2	Lacrimal gland ductulitis	Excision & dacryolith curettage
10	80/M	Right eye foreign body sensation	2	Dacryops	Marsupialization
11	34/F	Right pus like discharge	2	Lacrimal gland ductulitis	Excision & dacryolith curettage

M = male; F = female.

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