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

2. 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

4. Acrimal passage

5. 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

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

7. 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

8. 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.

9. 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

10. Acute dacryocystitis

11. Acute dacryocystitis

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

13. 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

14. Acute dacryoadenitis

15. 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

16. Chronic dacryoadenitis

17. Thank you!