Swellings of the lacrimal system Lacrimal sac mucocele

Swellings of the lacrimal system Lacrimal sac mucocele

This occurs from obstruction of the lacrimal duct beyond the sac and results in a fluctuant swelling that bulges out just below the medial canthus. It can become infected to give rise to a painful tense swelling (acute dacryocystitis). If untreated, it may give rise to a fistula. Treatment is by performing a bypass operation between the lacrimal sac and the nose (a dacryo - cystorhinostomy). Watering of the eye can also occur as a result of eversion of the lower lid (ectropion), which causes loss of contact between the lower punctum and the tear film, or from inturning lashes in entropion, and these must be distinguished from a mucocele. Lacrimal gland tumours These are swellings of the lacrimal glands, which lie in the upper lateral aspect of the orbit. Eventually they lead to impairment of ocular movements and displacement of the globe forwards, downwards and inwards. Pathologically the tumours resemble parotid tumours and they can be pleomorphic adenomas with or without malignant change, carcinomas or mucoepidermoid tumours.