Asymptomatic stones in the lacrimal canaliculus
Hongda Zhang, Maosheng Xu, Guanghao Qin, Jiayan Chen, Yifan Qi, Ling Xu, Wei He, Emmanuel Eric Pazo
Cataract & anterior segment surgery
Abstract
Key Clinical Message: Asymptomatic lacrimal canaliculus stones causing many stones without symptoms are rare. The patient recovered well within a week after dacryolith removal. This diagnosis is prevalent in this age group. However, asymptomatic nasolacrimal obstruction should be considered. Abstract: Dacryoliths, also known as symptomatic stones, are frequently observed in the lacrimal drainage system. These stones manifest through symptoms such as conjunctivitis, discharge, and epiphora. Nevertheless, the occurrence of numerous stones in the lacrimal canaliculus, in the absence of apparent symptoms, is uncommon. In this study, we present a case with the presence of several stones within the inferior lacrimal canaliculus. A female patient, aged 74, appeared with bilateral senile cataracts and was scheduled for cataract surgery. During a standard ocular examination, it was observed that the tear meniscus height in the left eye had a greater magnitude compared with the right eye. Canaliculitis with dacryolith was verified using a series of diagnostic procedures, including physical inspection, fluorescent dye disappearance test, palpation, 50 Mhz ultrasound biomicroscope scan, and irrigation of the lacrimal canaliculi. Upon surgical investigation, the canaliculus obstruction was confirmed, characterized by the existence of many tiny dacryolith formations inside the inferior canalicular system. Following the surgical excision of the dacryoliths, the patient experienced a full remission within a week. While it is common for individuals in this age range to receive this diagnosis, it is important to consider silent nasolacrimal blockage as a potential alternative diagnosis. It is important to note that the presence of dacryoliths in the lacrimal drainage system might manifest independently of conjunctivitis. No discernible risk indicators were found in relation to the aforementioned patient.
Keywords: dacryoliths; canaliculitis; nasolacrimal duct obstruction; lacrimal drainage system; epiphora; tear meniscus height; cataract surgery; elderly patients
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How to cite
@article{zhang2023asymptomatic,
title = {{Asymptomatic stones in the lacrimal canaliculus}},
author = {Zhang, Hongda and Xu, Maosheng and Qin, Guanghao and Chen, Jiayan and Qi, Yifan and Xu, Ling and He, Wei and Pazo, Emmanuel Eric},
journal = {Clinical Case Reports},
year = {2023},
doi = {10.1002/ccr3.8175},
url = {https://doi.org/10.1002/ccr3.8175},
}
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