Epiphora is one of the most common problems in ophthalmological practice, and is caused by dysfunction of the lacrimal pathway. The lacrimal drainage system is a continuous anatomical structure consisting of the lacrimal punctum, inferior and superior canaliculi, common canaliculus, lacrimal sac, and nasolacrimal duct. Lacrimal disease can be medically treated in case of acute inflammation or partial obstruction at the beginning of treatment, but surgical treatment is necessary in most cases. This paper discusses the etiology, clinical features, diagnosis, and surgical treatment of various lacrimal diseases through a selective review of the relevant literature. Advances in lacrimal duct surgery can now be performed in such a way that the structural integrity and normal physiological function of the entire efferent lacrimal pathway is preserved.
Dacryocystorhinostomy ; Diagnosis ; Drainage* ; Inflammation ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases ; Lacrimal Duct Obstruction ; Nasolacrimal Duct

PURPOSE: We conducted this study to evaluate the role of dacryoscintigraphy in the diagnosis and treatment of pediatric patients with epiphora. MATERIALS AND METHODS: In 58 patients aged from 2 months to 15 years (mean age 2.8+/-2.3 years), dacryoscintigraphy was performed using a gamma camera with 4 mm pinhole collimator. We correlated symptoms with dacryosicntigraphic findings in all patients. In 37 patients who underwent ophthalmologic procedures, we analyzed the agreements of dacryoscintigraphic findings with the operation. RESULTS: High rates of agreements between epiphora and obstruction on dacryoscintigraphy (69/72, 95.8%), and between scintigraphic obstructive findings and operation sites (44/47, 93.6%) were noted. Nine of fourty-four (20.5%) asymptomatic eyes showed obstructive findings on dacroscintigraphy. CONCLUSION: In pediatric patients with epiphora, dacryoscintigraphy is a useful tool not only in diagnosing nasolacrimal duct obstruction but also in making a decision for therapeutic procedures.
Diagnosis* ; Gamma Cameras ; Humans ; Lacrimal Apparatus Diseases* ; Nasolacrimal Duct

Punctal stenosis may be caused by several etiologies and easily treated by punctoplasty with accompanying procedures. History taking, external and slit-Iamp examinations, and diagnostic tests and imaging techniques of lacrimal system identified lacrimal system abnormalities. Occasionally satisfactory result was not gained after punctoplasty, so author introduce the simple test to aid diagnosis of punctal stenosis and to predict surgical result of punctoplasty. If the fluorescein dye disappearance test documents a dilation, additional fluorescein dye disappearance test was performed to evaluate the efficacy of punctal dilation to relieve the epiphora. This procedure will be helpful in the case of subtle punctal stenosis and evaluation of surgical result.
Constriction, Pathologic* ; Diagnosis ; Diagnostic Tests, Routine ; Fluorescein ; Lacrimal Apparatus Diseases*

We report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus. A systemically healthy 1-year-old girl came to the outpatient clinic with a complaint of tearing on the temporal side of the right lateral canthus since birth. On examination, a small orifice was found in the skin on the temporal side of the lateral canthus. There was no evidence of inflammation or swelling within the opening. Surgeons carried out an operation under general anesthesia. They passed a probe through the lacrimal orifice and advanced it toward the lacrimal sac. Next, they introduced saline to the inferior punctum and found that it drained to the lateral fistula. The lower lid stretched as the dissected fistula was pulled. After the operation, the patient was free of the symptom. This paper is to report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus.
Diagnosis, Differential ; *Eye Abnormalities ; Female ; Fistula/*congenital/diagnosis ; Humans ; Infant ; Lacrimal Apparatus/*abnormalities ; Lacrimal Apparatus Diseases/*congenital/diagnosis

PURPOSE: To compare the outcomes of endonasal dacryocystorhinostomy in patients with secondary lacrimal drainage obstruction associated with systemic chemotherapy or radioactive iodine therapy. METHODS: We retrospectively reviewed the clinical records of patients diagnosed with secondary lacrimal drainage obstruction after systemic chemotherapy or radioactive iodine therapy for thyroid disease and surgical treatment by endonasal dacryocystorhinostomy between January 2009 and January 2015. The control group included randomly selected patients who underwent endonasal dacryocystorhinostomy after diagnosis of primary lacrimal drainage obstruction. RESULTS: Patients were separated into a chemotherapy group (13 eyes of 9 patients), a radioactive iodine therapy group (44 eyes of 32 patients), and a control group (50 eyes of 40 patients). Duration from the onset of systemic chemotherapy or radioactive iodine to the first epiphora symptom was shorter in the chemotherapy group than the radioactive iodine therapy group (p < 0.001). There was no significant difference between the three groups in success rate of endonasal dacryocystorhinostomy. CONCLUSIONS: Most patients with secondary lacrimal drainage obstruction associated with systemic chemotherapy or radioactive iodine therapy had successful outcome of endonasal dacryocystorhinostomy. The success rate of dacryocystorhinostomy was comparable to that in patients with primary lacrimal drainage obstruction.
Dacryocystorhinostomy* ; Diagnosis ; Drainage* ; Drug Therapy* ; Humans ; Iodine* ; Lacrimal Apparatus Diseases ; Retrospective Studies ; Thyroid Diseases

The presence of complete obstruction within the human lacrimal drainage system can be easily found. The partial obstruction within the lacrimal drainage system can be diagnosed with Jones dye test and radiologic test. However, above tests can't determine the degree of partial obstruction as qualitative methods. Authors designed the instrument that measures the resistance to constant fluid flow within the nasolacrimal duct. Author measured the resistance to 5 ml/min flow rate with stainless steel canula (internal diameter, 0.395 mm) within the nasolacrimal duct in 194 people (388 eyes) without epiphora. The means of the resistance in all cases are 187.64+/-42.37 mmHg.seconds/ml. There are no statistical significances in both eyes and sex groups. But in age groups between teens and 20s, 30s and 40s, 60s and over 70s, there are statistically significant. Between the age and the resistance the coefficiency of correlation(r) is 0.56 in right eye, 0.64 in left eye, 0.60 in both eyes and as a result of regression, statistical significance showed (p-value<0.01). Authors suggested the normal value of the resistance in age and sex groups quantitatively. On the basis of this measurement, it is possible to make the early diagnosis and the proper plan of treatment in the partial obstruction of the nasolacrimal duct, the differential diagnosis between epiphora from the partial obstruction within the nasolacrimal duct and from other causes.
Adolescent ; Diagnosis, Differential ; Drainage ; Early Diagnosis ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Reference Values ; Stainless Steel

No abstract available.
Aged, 80 and over ; Amyloidosis/*complications/diagnosis ; Biopsy ; Dacryocystorhinostomy/methods ; Humans ; Lacrimal Apparatus/*diagnostic imaging/surgery ; Lacrimal Apparatus Diseases/*diagnosis/etiology/surgery ; Male ; Tomography, X-Ray Computed

Mucoepidermoid tumor of the lacrimal sac is exteremely rare. To our knowledge, there have been 4 cases reported in the literature and no case was reported in Korea. We have experienced a 77-year-old male patient complaining of epiphora and medial canthal area mass of 5-month duration in the right eye. On biopsy findings, many cystic structures containing mucin were seen, of which wall consisted of neoplastic mucin-secreting cell components and small nests of epidermoid cells. The diagnosis of mucoepidermoid tumor was made.
Aged ; Biopsy ; Cellular Structures ; Diagnosis ; Humans ; Korea ; Lacrimal Apparatus Diseases ; Male ; Mucins ; Mucoepidermoid Tumor*

Lacrimal sac tumors are relatively rare and epithelial origin, mostly. The clinical menifestations of lacrimal sac tumors include epiphora, chronic dacrtocystitis, or lacrimal mass. Primary neurofibroma of lacrimal sac is benign nature and malignant transformation is rare. But malignant lacrimal sac tumors can be life-threatening; Therefore, the early diagnosis and treatment are important. We reported an experience of a 37-year-old female who had epiphora, pruritis, lacrimal mass, and facial asymmetry. The patient was finally diagnosed with pigmented neurofibroma of lacrimal sac that was proven by dacryocystogram, CT scan, and histophthologic finding.
Adult ; Early Diagnosis ; Facial Asymmetry ; Female ; Humans ; Lacrimal Apparatus Diseases ; Neurofibroma* ; Pruritus ; Tomography, X-Ray Computed

PURPOSE: To investigate the efficacy and safety of adjunctive Mitomycin C (MMC) during silicone intubation (SI) for treatment of acquired incomplete nasolacrimal duct obstruction (NLDO). METHODS: Nineteen eyes with incomplete NLDO underwent SI only (group I). 20 different eyes were administered adjunctive 0.4 mg/ml MMC for 4 minutes (group II). Diagnosis of incomplete NLDO was based upon subjective complaints of tearing, dye disappearance testing, clinical evidence of epiphora, and nasolacrimal duct irrigation. Follow-up examination was conducted at 1, 3, and 6 months. RESULTS: Follow-up ranged from 3 to 15 months (mean, 6.1 months). Twelve (63.1%) eyes in group I and 14 (70.0%) eyes in group II had a successful outcome and remained symptom-free. Four (21.1%) eyes in group I and three (15.0%) eyes in group II showed improvement but still experienced periodic epiphora. The difference was not statistically significant (p=0.873). CONCLUSIONS: SI as a treatment for incomplete NLDO provides complete relief or substantial improvement in a significant percentage of patients but MMC application during SI did not benefit outcome.
Diagnosis ; Follow-Up Studies ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Mitomycin* ; Nasolacrimal Duct* ; Silicones*