Presentation
Their clinical presentation is rare, and their bilateral presentation is encountered even less frequently. We present the clinical, histopathologic, and CT appearance of bilateral dacryops as a unique case. [ajronline.org]
A definitive and prompt diagnosis can be made after an histopathological examination where the cyst is present with one to two layers of epithelium and a clear lumen. [icliniq.com]
Although it can arise in any location where lacrimal gland tissue is present, it usually presents as painless swelling under the lateral aspect of the upper eyelid. [hindawi.com]
Typically, they present at the superotemporal eyelid fornix where the most lacrimal gland tissue is present. [bmcophthalmol.biomedcentral.com]
Entire Body System
- Swelling
A 48-year-old Korean American woman was referred to the oculoplastics department at our institution with bilateral eyelid swelling. The swelling had been present for the past 5 years but had progressed over the past year. [ajronline.org]
Presentation A 43-year-old woman noted swelling and pain around her right eye for two weeks. She denied trauma, visual change or diplopia. [reviewofophthalmology.com]
Patients present with painless swelling in the lateral portion of the upper eyelid. Cyst formation is related to periductal inflammation or trauma with secondary duct obstruction due to lacrimal gland hypersecretion and damage to duct walls. [ajnr.org]
Although it can arise in any location where lacrimal gland tissue is present, it usually presents as painless swelling under the lateral aspect of the upper eyelid. [hindawi.com]
- Inflammation
Findings from an external examination were normal: no inflammation, masses, or proptosis. The findings of the ocular motility examination was normal. [ajronline.org]
Histopathological examination showed immunoreactivity to IgA on the luminal surface of the epithelial ductal cyst and mild chronic inflammation in the underlying stroma or lacrimal gland. [jamanetwork.com]
Etiopathogenesis of dacryops is not clearly known, but it is speculated that preceding trauma or inflammation results in ductal wall damage. [hindawi.com]
Frozen sections revealed benign lacrimal tissue with epithelial cyst and associated acute and chronic inflammation and hemosiderin deposition consistent with dacryops. [reviewofophthalmology.com]
- Pain
It does not look red, but it is extremely painful. My eyes and forehead also hurt and is causing a very painful headache. I have chroni... [icliniq.com]
Dacryops can occasionally become infected as well, leading to painful enlargement. [reviewofophthalmology.com]
The most common symptom was non-painful upper eyelid mass. All patients had the visible protruding cyst while eversion of the upper eyelid. Imaging studies, including orbital computerized tomography and ultrasonography were performed in six cases. [pubmed.ncbi.nlm.nih.gov]
There was no associated pain, erythema, or discharge. And past medical history of the patient was negative for any orbital trauma or infection. During ophthalmological examination, corrected visual acuity was 20/20 OD and 20/20 OS. [hindawi.com]
She had no associated pain, erythema, or discharge. She denied any history of orbital trauma or infection. The patient's visual acuity was 20/20 right and left with corrective eye glasses. [ajronline.org]
- Asymptomatic
Dacryops is usually asymptomatic but can present with varied symptoms depending on the type and associated complications. [pubmed.ncbi.nlm.nih.gov]
Small, asymptomatic cases of dacryops can be safely monitored with serial eye exams. [parjournal.net]
Smaller cysts that are asymptomatic can be observed. Dr. Fenton would like to thank Carol Shields, MD, of the Ocular Oncology Service at Wills Eye Institute, for her assistance with this case. Shields JA, Shields CL, Scartozzi R. [reviewofophthalmology.com]
It is usually asymptomatic, sometimes it presents with varied signs and symptoms depending on the type and associated complications. Previously it was thought that dacryops develops due to obstruction or subsequent build-up of secretions. [icliniq.com]
Eyes
- Lacrimation
The cysts usually are surrounded by lacrimal glandular tissue and dilated lacrimal gland ducts [4]. [ajronline.org]
Harris GJ: Marsupialization of the lacrimal gland cyst. Ophthalmic Surg 1983;14:75–78. [karger.com]
Lacrimal gland duct cysts. Ophthalmic Surg. 1985; 16: 301-306 Bullock J.D. Fleishman J.A. Rosset J.S. Lacrimal ductal cysts. Ophthalmology. 1986; 93: 1355-1360 Smith S. Rootman J. Lacrimal ductal cysts. Presentation and management. [ajo.com]
Keywords: Dacryops; lacrimal ductal cyst; lacrimal gland cyst; lacrimal gland tumors; orbital cyst. Comment in Re: Lacrimal gland orbital lobe cysts. McNab AA. McNab AA. Orbit. 2020 Jun;39(3):230. doi: 10.1080/01676830.2019.1683211. [pubmed.ncbi.nlm.nih.gov]
- Foreign Body Sensation
Swelling of the upper eyelid Upper eyelid full laterally; eversion of the upper eyelid revealed a large clear cyst None No 2 11 43/F Right 1 wk Foreign body sensation and redness at lateral canthus Superotemporal orbital/lacrimal gland cyst with area [entokey.com]
Case presentation A 53-year-old man complained of a painless swelling of the right upper lid for 2 months accompanied with foreign body sensation and lachrymation. [bmcophthalmol.biomedcentral.com]
Neurologic
- Irritability
Besides eyelid fullness, symptoms of mild pain and ocular irritation were noted in 7 cysts, whereas the rest of the lesions were completely asymptomatic, including that of 1 patient whose lesion was discovered during levator surgery. [entokey.com]
Some patients also report tenderness and irritation. How Is Dacryops Classified? Dacryops can be classified depending on the location of the cyst, which includes: Palpebral lobe cysts - these cysts are found between the medial and lateral canthi. [icliniq.com]
Aching, irritation, and tenderness have been reported, which are usually mild. Signs Blepharochalasis or a conjunctival mass can be seen, depending on the anatomical location of the cyst. [eyewiki.aao.org]
- Confusion
It was seldom diagnosed accurately for many reports in the literature were both confusing and inaccurate. There was a similar case of ectopic dacryops above the orbit was later thought to be a Wolfring’s accessory lacrimal gland cyst [11, 16]. [bmcophthalmol.biomedcentral.com]
Workup
Diagnosis and Workup The cystic mass was clinically suspected to represent a large inflamed dacryops, but adenoid cystic carcinoma of the lacrimal gland could not be excluded. Surgical excision was advised. [reviewofophthalmology.com]
Treatment
While complete excision of dacryops is generally recommended, marsupialization is also a safe and effective method for the treatment of dacryops in the palpebral lobe of lacrimal gland. [pubmed.ncbi.nlm.nih.gov]
Surgery is found to be the mainstay of treatment for symptomatic cases. What Is a Lacrimal System? The lacrimal system involves the structures that help in the production and drainage of tears. [icliniq.com]
MRI fluid intensity cyst with no post-contrast enhancement 1 Nuclear Medicine Tc-99m pertechnetate scintigraphy: marked uptake 1 Treatment and prognosis Surgical excision or marsupialization in patients with symptoms or poor cosmesis 1. [radiopaedia.org]
Prognosis
MRI fluid intensity cyst with no post-contrast enhancement 1 Nuclear Medicine Tc-99m pertechnetate scintigraphy: marked uptake 1 Treatment and prognosis Surgical excision or marsupialization in patients with symptoms or poor cosmesis 1. [radiopaedia.org]
Prognosis Recurrence of the lesion after excision has been described, thought to be a result of incomplete removal.[1] Risks of injury and scarring of the lacrimal gland ductules may also occur. [eyewiki.aao.org]
Etiology
The exact etiology of dacryops remains unknown. Dacryops is usually asymptomatic but can present with varied symptoms depending on the type and associated complications. [pubmed.ncbi.nlm.nih.gov]
Etiology Worldwide, trachoma is thought to be the most common etiology. [eyewiki.aao.org]
Epidemiology
Data reviewed included epidemiology, etiology, pathogenesis, clinical presentations, histopathologic characteristics and management of dacryops.Results: Lacrimal ductal cysts or dacryops are classified based on locations: palpebral lobe cysts (simple [pubmed.ncbi.nlm.nih.gov]
Pathophysiology
It is can be due to primary or secondary causes, although the pathophysiology is unclear. [radiopaedia.org]
Pathophysiology Although these lesions have been known to medical science for quite some time, disagreement persists regarding their etiology. [eyewiki.aao.org]
Prevention
Excision with or without marsupialization is known to prevent recurrence and drainage of the cyst. In addition, antibiotic therapy can successfully manage the infection and cyst size. [icliniq.com]
Declarations Acknowledgments The authors thank Research to Prevent Blindness (RPB) for their support of the UC San Diego Shiley Eye Center. [parjournal.net]