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ARTICLES
Year : 1982  |  Volume : 30  |  Issue : 5  |  Page : 513

Rhinosporidiosis of lacrimal sac


Department of Ophthalmology J.N.M. Medical College, Raipur, India

Correspondence Address:
P K Mukherjee
Dept. of Ophthalmology, J.N.M. Medical College, Raipur
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Mukherjee P K, Shukla I M, Deshpande M, Kher P. Rhinosporidiosis of lacrimal sac. Indian J Ophthalmol 1982;30:513

How to cite this URL:
Mukherjee P K, Shukla I M, Deshpande M, Kher P. Rhinosporidiosis of lacrimal sac. Indian J Ophthalmol [serial online] 1982 [cited 2020 Nov 27];30:513. Available from: https://www.ijo.in/text.asp?1982/30/5/513/29247

Rhinospordiosis in man is seen in certain coastal states. For this is a study on 48 cases of this disease involving the lacrimal sac, seen in this region.


  Observations and discussion Top


In a series of 414 cases of dacryocystitis seen during 2 years period (1978-1980) 48 were due to rhinosporidiosis. The eldest patient was 35 years old. The majority were children, The age distribution was as under :- less than 10 years-23; 1 1-20 years 19 and above the age of 2t years 6. Mules (32) were twice as often affected than females (16). Right sac was involved in 25 and left side in 21. Three cases has bilateral involvement.

Only sac was involved in 42 cases. Nose was also involved in only 6 cases. There was no evidence of systemic involvement, nor was any case where conjunctiva was involved. In­voivemenl of the sac, therefore appears pri­mary in most cases.

Clinical presentations were as follows Diffuse swelling over the sac-45; Widen­ing of the nose bridge-42; swelling extending under the lower lid-30; Localised swelling over the sac-3; Bleeding from the nose - 6.

It will be seen that the two most common presenting features were diffuse swelling over the sac and widening of the nose bridge on the side involved. Bleeding from the nose was seen in ali the cases with nasal involvement.

Characteristic of the swelling due to Rhino sporidiosis of lacrimal sac were :­

Diffuse- soft. non tender; limited superiorily by the roof of the orbit, medially by nose; Extends diffusely under the letter lid: the skin over the swelling shows small pits, giving an appearance of orange peal; tendency to erode surrounding bone; absence of regurgitation and epiphora.

Normally there is neither regurgitation from the swelling nor epiphora in cases of rhinosporidiosis of the sac which is so common in usual type of chronic dacryo cystitis.

Syringing of the involved sac revealed complete block in 75 per cent case lest showed partial block. The fluid injected from syrin~ ing did not regurgitate through the puncta in 60 per cent cases of complete block, but accumulated in the swelling inflating it. The inflated swelling could be reduced by gentle pressure over the sac, evacuating the fluid through the puncta.

The only treatment known is surgical rcmoval of the involved sac completely with mass of rhinosporidiosis. The rhinoporidiosis granuloma, in all cases bleed profusely but the bleeding is not troublesome as it can be con­trolled with packing and once the mass is removed the bleeding is completely stopped. Mecurrence of rhinosporidiosis is well known, but fortunately in none in this series of cases there was recurrence.


  Summary Top


Rhinosporidiosis was the etiology in 48 cases out of a series of 414 cases of chronic dacryocystitis. Out of which 42 were under 20. Preexisting obstruction seems to be a factor in production of the lesion. Clinical features rhinosporidiosis of the sac has been described.




 

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