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Dacryolithiasis and dacryocele: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Dacryolithiasis
Dacryoliths (tear stones) can occur in any part of the lacrimal system, more often in men. Although the pathogenesis of dacryolithiasis is not entirely clear, it is suggested that secondary stagnation of tears during inflammatory obstruction may accelerate the formation of dacryoliths and squamous metaplasia of the lacrimal sac epithelium.
Features of dacryolithiasis
- Dacryoliths are usually asymptomatic and may be detected during dacryocystorhinostomy.
- Some patients (usually elderly) complain of inconstant lacrimation, frequent exacerbations of dacryocystitis and stretching of the lacrimal sac.
Symptoms of dacryolithiasis
- The lacrimal sac is enlarged and quite hard, but not inflamed and soft, as in acute dacryocystitis.
- Reflux of mucus when pressing is not required.
Treatment of dacryolithiasis includes massage, lavage of the lacrimal ducts and probing; in case of complete obstruction, dacryocystorhiostomy is indicated.
Congenital dacryocele is a collection of amniotic fluid or mucus in the lacrimal sac caused by an imperforate Ilasner valve.
[ Congenital dacryocele
Congenital dacryocele is manifested by a perinatal cystic formation of a bluish color just below the inner corner of the eye, which is accompanied by lacrimation.
Symptoms of dacryocele include a dense tear sac that is initially filled with mucus and may later become infected.
A dacryocele may be mistaken for an encephalocele, which is characterized by a pulsating swelling above the level of the internal commissure of the canthus.
Treatment of dacryocele is initially conservative; if it is ineffective, probing should not be postponed.
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