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ARTICLES
Year : 1986  |  Volume : 34  |  Issue : 1  |  Page : 69-70

Cystic dilatation of diverticulum of canaliculus and its management


Department of Ophthalmology, S.P Medical College and Associated Group of Hospitals Bikaner, India

Correspondence Address:
Ashok Kumar Sharma
Raj Bhawan, Behind Head Post Office, Bikaner-334001
India
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Source of Support: None, Conflict of Interest: None


PMID: 3127341

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How to cite this article:
Sharma AK, Sahai R, Acharya O P, Wadhwa O P. Cystic dilatation of diverticulum of canaliculus and its management. Indian J Ophthalmol 1986;34:69-70

How to cite this URL:
Sharma AK, Sahai R, Acharya O P, Wadhwa O P. Cystic dilatation of diverticulum of canaliculus and its management. Indian J Ophthalmol [serial online] 1986 [cited 2020 Feb 23];34:69-70. Available from: http://www.ijo.in/text.asp?1986/34/1/69/26459

Cyst and diverticula of the canaliculi are extremely rare. Cysts have a congenital basis, arising from a diverticula[1]. They become evident by projecting on the lid margin as a cystic tumour (Wilson 1936)[2]. The present case represent this rare condition and a simple surgical technique to correct the disease is reported.


  Case report Top


Patient 40 years male, presented with the complaint of a small swelling on medial side of right lower lid for last two years. Swelling increased in size, alongwith the complaint of epiphora and mucopurulent discharge for last one year. There was no swelling or any other complaint before that. For the complaint patient took treatment at different places but he bad no relief.

There was a small swelling (10 x 8 mm size) on medial side of right lower punctum visible both on conjunctival and skin side [Figure - 1]. There was conjunctival con­gestion localised to medial canthus in bulbar as well as palpabral conjunctiva alongwith mucopurulent discharge. On pressure over sac there was no regurgitation but pressure over swelling resulted in a thick semi solid discharge from puncta, which could be taken out with difficulty. The Syringing of right lacrimal passages through lower puncta reveal­ed that passages were patent. Dacryocysto­gram-Radio-opaque dye (Lipoidol) was injected through lower puncta which revealed a cystic diverticula alongwith lower canali­culus and a normal dye in lacrimal sac [Figure - 2] a & b.

The material expressed from the cystic diverticula through lower canaliculi was sent for culture and sensitivity but no pathogenic organism could be grown.

We decided to go for opening the cystic diverlicula in conjunctival sac by making a opening at its most depended part. A Bow­man's prove was passed in cystic diverticula and the conjunctiva over it was excised so as to make a round hole of about 1 mm. size. A polythene tube was inserted through lower puncta so that it eomes out through the hole of conjunctival side. then the two ends of this polythene tube were sutured together. The tube was left in position for three week: so that when the fibrosis occurs the hole made by us could not close [Figure 3] A & B. Tube was removed after 3 weeks and till follow up there was no complaint to the patient.


  Comments Top


Cystic diverticula of the canaliculi have not been described in the literature. The present case is of same condition and a surgi­cal technique to correct it has been performed by us. Results were satisfactory. Later we found out that same operation was performed by Bowers [3] but they did not introduced a polythene tube to make a permanent patent opening. No other reference in the literature about this type of operation is available. It is necessary that the opening made should remain patent so that there is no collec­tion of secretions again. Normal drainage should also be maintained which was achiev­ed by passing a polythene tube. Case has to be differentiated from (1) Cyst of overlying skin (sebaceous cyst) (2) Chalazion (3) Dermoid (4) Pseudo-tumour/granuloma asso­ciated with canaliculitis of some standing due to mycotic infections, foreign body, trauma.


  Summary Top


A case of cystic diverticulum of lower canaliculus has been described alongwith a new surgical technique for its correction[3].

 
  References Top

1.
Duke-Elder S. 1974. System of Ophthalmology Henry Kimpton-Ocular adenexa-London V. XIII Part II, 733.  Back to cited text no. 1
    
2.
Wilson R. P., 1936, Repmem. Ophthal. Lab Giza, 11; 78, Cited by Duke Elder S, System of Ophthalmology. V. XIII. Part 2 P. 733  Back to cited text no. 2
    
3.
Bowers and Simmons, 1970 Arch. Ophthal­mol. 83 :61.  Back to cited text no. 3
    


    Figures

  [Figure - 1], [Figure - 2]



 

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