Tears and lacrimation

Question 1

Features and Rx of acute dacryocystitis (3)

Answer 1

inflammation of lacrimal sac
can>cellulitis
Rx w. immediate Abx.

Question 2

Nasolacrimal duct obstruction/non-canalisation features and Mx (3)

Answer 2

may not be open at birth, should open by 1yr
leads to watery eyes and conjunctivitis
teach parents nasolacrimal massage.

Question 3

Features, Ix and Mx of chronic dacryocystitis (3)

Answer 3

lacrimal sac distends>secretes pus into eye>blocked nasolacrimal duct
CT of orbit if orbital cellulitis
Mx w. dacryocystorhinostomy to establish connection between lacrimal sac and nasal cavity if permanently blocked.

Question 4

Dacroadenitis features and causes (6)

Answer 4

inflammation of lacrimal gland
causes:
-mumps
-measles
-flu
-gonorrhoea
-chronic in TB, sarcoid and lymphatic leukemia

Question 5

Broad causes of keratoconjunctivitis sicca (2)

Answer 5

decreased tear production

mucin deficiency in tears

Question 6

Causes of decreased tear production>keratoconjunctivitis sicca (8)

Answer 6

old age
mumps
sjogren's
haemachromatosis
sarcoidosis
amyloidosis
lymphoma
leukemia

Question 7

Causes of decreased mucin production>keratoconjunctivitis sicca (3)

Answer 7

vitamin deficiency
stevens-johnson
pemphigoid

Question 8

Ix and Rx for keratoconjunctivitis sicca (2)

Answer 8

Schirmer’s test (paper in lower lid)

Rx w. artificial tears.

Question 9

causes of excess lacrimation (9)

Answer 9

improper drainage, increased lacrimation, pump failure:

• ectropion/entropion
• punctal stenosis/canaliculitis
• emotion
• corneal injury
• iritis
• conjunctivitis
• acute glaucoma
• VIIth nerve palsy
• myasthenia