Diseases of the Lacrimal Gland

Notes to accompany tutorial presented in 03 Lacrimal Anomalies Module


Dr Simon Barnard PhD BSc FCOptom FAAO DCLP

Introduction

Lacrimal gland lies in the anterior lateral portion of the orbit in the lacrimal fossa

Large orbital portion (3 - 5 ducts) and smaller palpebral portion (5 - 7 ducts)

See 01 and 02 Anatomy notes for blood supply and innervation

Inflammations of the lacrimal gland

May be bilateral

ACUTE BACTERIAL DACRYOADENITIS

ACUTE VIRAL DACRYOADENITIS

 

CHRONIC DACRYOADENITIS (MIKULICZ’S SYNDROME)

Symptoms and signs

Sarcoidosis may be a possible cause in which case…

Other causes include:

ORBITAL INFLAMMATORY PSEUDOTUMOUR

 

Tumours of the lacrimal gland

Clinical signs

Symptoms

 

 

 

 

Classification of lacrimal gland tumours

BENIGN

Dermoid cyst

 

MALIGNANT

Malignant mixed epithelial tumours (Pleomorphic adenocarcinoma)

Mucoepidermoid carcinoma

 

Other anomalies

Lacrimal gland cyst (Dacryops)

Sjogren’s syndrome

 

 

 

GENERAL INVESTIGATION

History

Ocular examination

 

Orbital CT Scan (MRI rarely required)

Consider chest x-rays (Sarcoidosis/TB)

Systemic investigations by hematologist/oncologist

Lacrimal biopsy when a malignant tumour is suspected/diagnosis uncertain

Treatment

References

Char D.H. (1989) Clinical Ocular Oncology, Churchill Livingstone, London