Disease of the lacrimal apparatus The Fourth Affiliated Hospital of China Medical University Ophthalmology Hospital of China Medical University

Disease of the lacrimal apparatus Secretory systems: lacrimal gland: reflex secretion accessory lacrimal gland: basic secretion conjunctival goblet cells: mucoprotein meibomian glands : lipid sebaceous gland of the palpebral margin: lipid Drainage systems : upper,lower pancta upper, lower lacrimal canaliculi common canaliculus lacrimal sac nasolacrimal duct

Acrimal passage

Disease of drainage systems Ctiology Category Clinical findings Congrnital occlusion, inflammati-on and injure in general obstruction of puncta obstruction of lacrimal canaliculi obstruction of lacrimal sac and nasolacrimal duct

Examine Method Dye test Syringing of lacrimal passages Probing of lacrimal passage X-ray lipiodolography

Chronic dacryocystitis Definition : it is a common ophthalmopathy, due to narrow or obstruction of nasolacrimal duct, tears retain in the lacrimal sac complicated by bacterial infection. Etiology: kinds of infections induce narrow or obstruction of nasolacrimal duct. Diagnosis: 1.epiphora, eczema on neighboring 2.mucous or mucopurulent secretion flowing out from the lacrimal punctum 3. Syringing of lacrimal passages

Treatment: Drop antibiotic eyedrops Dacryocystorhinostomy Laser lacryocystoplasty Probing of lacrimal passage It is potential focus of infection which can cause endophthalmitis when operating on the eye. It is must be cured before an operation.

Acute dacryocystitis Diagnosis: Treatment: It commonly takes place on the basis of chronic one ,related to strong toxicity of invader or injure and lower resistance. Diagnosis: A. the local skin is red and swollen. B. submandibular lymph nodes is swollen and with severe tenderness C. the abscess may rupture and penetrate the skin to drain out D.general system Treatment: Local hot compression Antibiotic eyedrops and systemic use of antibiotic Incision and drainage

Acute dacryocystitis

Acute dacryocystitis

Secretory systems Dacryoadenitis acute dacryoadenitis chronic dacryoadenitis Tumor of the lacrimal gland

Acute dacryoadenitis Etiology : primary infection Diagnosis: Blood diffusion and local focus extending Diagnosis: - pain at lacrimal  area, edema of the upper eyelid and tears - the abscess may rupture, lymph nodes swelling and lacrimal  area with severe tenderness - general systems Treatment: antibiotic Local hot compression Incision and drainage

Acute dacryoadenitis

Chronic dacryoadenitis Etiology: protracted course of the acute one primary chronic infection relation to Phymatiasis and collagen disease Diagnosis: swelling of upper eyelid and ptosis lacrimal gland is obulated without tenderness Treatment: causative treatment

Chronic dacryoadenitis

Thank you!