Bilateral Nasolacrimal Duct Obstruction and Lacrimal Gland Enlargement as Only Initial Signs of Systemic Sarcoidosis
Author: Mehmet Serhat Mangan
Base Hospital / Institution: University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Division of Ophthalmic Plastic and Reconstructive Surgery
Video presentation
Abstract ID: 24-213
Purpose
Sarcoidosis is an idiopathic, multisystemic inflammatory disease that can affect skin, lungs, lymph nodes as well as orbita. This video demonstrates orbitotomy with excision of the enlarged lacrimal gland secondary to sarcoidosis.
Methods
A 48-year-old male patient has presented with epiphora and swelling of the upper eyelids. Radiological imaging revealed enlargement in the bilateral lacrimal gland. Biopsy taken from the lacrimal gland showed non-necrotizing granulomatous inflammation consistent with sarcoidosis. Due to bilateral nasolacrimal duct obstruction, bilateral external dacryocystorhinostomy was performed in separate sessions. Biopsy results from the lacrimal sac were in line with sarcoidosis. Subsequent follow-up showed an increase in lacrimal gland size, prompting bilateral orbitotomy with excision of the enlarged lacrimal gland. Biopsy resulted in sarcoidosis once again, confirming the previous rounds of diagnoses. Bilateral Müller’s muscle conjunctival resection was performed due to blepharoptosis following the bilateral orbitotomy surgeries.
Results
Following the series of procedures, sarcoidosis patient’s initial presenting symptoms of lacrimal gland enlargement, ptosis and epiphora has resolved.
Conclusion
Sarcoidosis is a common multisystemic disease that can affect orbit. Even though the disease has been presented various systemic manifestations, our study has shown that sarcoidosis can present solely with the initial signs of bilateral nasolacrimal duct obstruction and lacrimal gland enlargement.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Ayse Merve | Ekincikli | University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Division of Ophthalmic Plastic and Reconstructive Surgery |
