The role of entrapped cilia on the formation of lacrimal ductular cysts

Lash Impaction in Meibomian Gland Orifice

Purpose

To analyze potential risk factors associated with eyelash impaction into meibomian gland orifice.

Methods

Retrospective review of one tertiary clinic over a period of 10 years.

Results

In this study, 18 patients were included, with a mean age of 61.6 years at diagnosis. Ten patients were symptomatic in the form of ocular irritation or foreign body sensation. The location of the impaction included 15 nasal half and 3 temporal half of the lid, 6 upper lid and 12 lower lid, 8 right side and 10 left side. Risk factors included dry eyes (10), allergic conjunctivitis (4), severe rubbing of the eye (6), sleeping on the eye (2), and recent phacoemulsification (1).

Conclusion

Ocular rubbing from either ocular allergy or dryness is associated with impaction of the lash into the orifice of the meibomian gland duct.

Long-term Outcome of Incision and Curettage Treatment in Patients with Lacrimal Gland Ductulitis

Purpose

To describe the effects and long-term outcomes of incision and curettage treatment in patients with lacrimal gland ductulitis.

Methods

Twenty-four patients (24 eyes) with lacrimal gland ductulitis who were treated at Saevit Eye Hospital from June 2010 to November 2016. All patients underwent incision and curettage through the lacrimal ductule, and granules or concretions were removed. After the procedure, oral and topical antibiotics, oral anti-inflammatory agent were used for a week. Clinical presentations of the patients were analyzed. The resolution of symptoms and inflammatory signs and recurrence were evaluated more than 12 months after the procedure including telephone follow-up by a specialist nurse.

Results

Common symptoms were a painful, swelling mass with mucous discharge (17 eyes) and conjunctival injection (7 eyes) at the lateral canthal area. During the procedure, 22 patients (91.7%) had typical sulfur granule of Actinomyces, and 10 patients (41.7%) had many cilia in the expressed debris from the ductule. Twenty-three of 24 patients had resolution of symptoms after the procedure and all but one patient (95.8%) showed no recurrence.

Conclusions

Incision and curettage is a simple and less invasive procedure that may be considered as a first treatment option for lacrimal gland ductulitis. Furthermore, incision and curettage of the affected lacrimal ductule has been shown to be effective at minimizing long-term recurrence of lacrimal ductulitis.