Year : 1985 | Volume
: 33 | Issue : 1 | Page : 65--66
Ectopic lacrimal gland in the eyelids
Nikhil C Kaushik
Manchester Royal Eye Hospital Oxford (U.K)
Nikhil C Kaushik
Kaushik Manchester Royal Eye Hospital Oxford Road Manchester M 13 9WL, UK
|How to cite this article:|
Kaushik NC. Ectopic lacrimal gland in the eyelids.Indian J Ophthalmol 1985;33:65-66
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Kaushik NC. Ectopic lacrimal gland in the eyelids. Indian J Ophthalmol [serial online] 1985 [cited 2020 Sep 28 ];33:65-66
Available from: http://www.ijo.in/text.asp?1985/33/1/65/27338
Ectopic tissue from the lacrimal gland is a rare clinical condition. Cases have been recorded in literature where ectopic lacrimal tissue has been found at varying sites in and around the eye,.
This report describes a case of ectopic lacrimal tissue in the substance of the upper eyelids, and is interesting in being bilateral.
Mr. N. D. aged 19 presented with puffiness of his upper eyelids for the past two years. The lids felt heavy and irritable most of the mornings. The puffiness eased slightly by noon and remained unaltered for the rest of the day.
Apart from this he enjoyed good health and this was his first ever attendance for any medical need.
On inspection the upper eyelids were swollen [Figure 1], with slight bulge on the lateral aspects. No lump was palpable. Rest of the ocular and general examination was normal.
The diffuse and slightly fluctuating swelling of the eyelids raised the possibility of some systemic involvement.
Investigations were within normal limits.
The right upper lid was explored surgically through a supra-tarsal transverse incision in line with the upper palpebral furrow. A mass of firm lobulated tissue measuring approximately 10 mm x 3 mm x 4 mm, was found in front of the tarsal plate lying freely in the plane of the orbicularis muscle, unconnected to any other structure.
This was removed and a more normal palpebral furrow constructed.
Histopathology revealed the tissue as lobules of lacrimal gland with some dilated ducts [Figure 2].
The swelling of the right upper lid largely resolved, and three months later a similar nodule was removed from the left upper eyelid. The patient has since been symptom free, and the eyelid now look more normal.
The lacrimal gland develops from the basal conjunctival cells as solid buds at 8 weeks gestation (20 mm stage).
These buds gradually migrate and finally come to lie in the lacrimal gland fossa. The tissue continues to grow after birth and complete differentiation occurs only after three years of age. The accessory lacrimal glands are similarly formed as ectodermal evaginations of the conjunctiva.
During this process of development a part of the gland may get sequestered and develop separately, unconnected to the main mass of the lacrimal gland.
The secretions from ectopic tissue may accumulate and excite an inflammatory reaction, in the abnormal site.
Should the ectopic tissue lie deep in the orbit it may present as proptosis at any age.
In this patient, the puffiness of the lids would likewise seem to be related to the collection of glandular secretions in the substance of the eyelids.
This condition should be remembered in cases presenting with lid swelling of this nature.
The ectopic lacrimal gland tissue is a rare clinical entity. Presentation of such a case depends upon the site where the ectopic tissue lies. Secretions from the ectopic gland may accumulate in the involved tissues, and frequently a suspicion of some systemic disorder or neoplasia is aroused. The diagnosis is rarely made on clinical grounds alone, and rests on the histopathological studies.
I am grateful to Mr. R Dalgleish FRCS., Senior Consultant at the Manchester Royal Eye Hospital, for permission to report this patient under his care.
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