Nagalakshmi Narayana-Swamy

Abstract

Purpose: Dacryops, is a clinical entity of unknown aetiology. Here we present the clinical features and radiological presentation of a bilateral dacryops as a unique case. Case Description: A 36year old woman presented with unilateral lid swelling, since 7years non-perceptible but obvious on reflex tear secretion. However, she had no complaints of pain, redness, discharge. On examination, vision was normal and lacrimal ducts were patent. Mass in the left eye was noted on reflex tear secretion such as exposure to air/chewing. No signs of inflammation present. Tear film tests were normal. Fundus, routine blood parameters and serum ACE was negative. Ultrasonography of the orbits showed well defined hypoechoiec cystic lesion along lateral aspect of left globe and CT showed bilateral predominantly cystic lesion more prominent on left compared to right. Bilateral Dacryops, is unusual. Thus it becomes essential that clinicians are aware of this condition and consider it as one of the differential diagnosis of the lacrimal gland masses. Results: A case of bilateral dacryops detected incidentally, was investigated and followed up. Conclusion: Dacryops, or a lacrimal gland ductal cyst, is a rare clinical entity, whose bilateral presentation is unusual. It is essential that we as clinician’s are aware of this condition and consider it as a differential diagnosis of the lacrimal gland masses. Keywords: Dacryops, Orbit, Lacrimal gland.

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Abstract

Purpose: Thyroid Orbitopathy is a condition associated with thyroid dysfunction. In addition to exophthalmos, eyelid retraction, eyelid oedema, restrictive extra-ocular myopathy, lacrimal gland enlargement can also be observed in these patients. However thyroid orbitopathy is not usually been considered in the differential diagnosis of cases of isolated lacrimal gland enlargement. Materials and Methods: An elderly male patient at our institution presented with bilateral lacrimal gland enlargement as the clinical or radiologic sign and was later diagnosed as thyroid orbitopathy. Computerized tomography and/or magnetic resonance imaging of the orbits were obtained and demonstrated isolated lacrimal gland enlargement with enlargement of lateral rectus and inferior rectus. Result: A case of bilateral lacrimal gland enlargement found in a patient with thyroid orbitopathy was noted. Patient was investigated and kept on follow up. Conclusion: This case represents, enlargement of lacrimal gland as a presenting sign of thyroid orbitopathy. Further clinical and radiological studies are essential for a better understanding of the timing of lacrimal gland involvement. In such patients presenting with lacrimal gland enlargement, thyroid orbitopathy should be strongly considere d in the differential diagnosis in addition to causes such as of dacryo-adenitis and neoplasms. Keywords: Lacrimal Gland, Orbit, Thyroid Orbitopathy.

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