I have a patient with mucocele on left side and watering of the eye on applaying pressure over the sac area the content of the sac comes through nostrils no regurgitation through punctum what could be the management for this patient
Dr krishnamurthy ramanaikResponses
Dear Dr. Ramanaik
You are most likely dealing with a patient with Atonic Lacrimal Sac with functional nasolacrimal duct obstruction. If the patient has symptomatic epiphora the treatment remains a DCR which would rid the patient of both watering and a recurrent sac swelling.
Dr. Hrishikesh Tadwalkar No:2
Dear Dr krishnamurthy ramanaik,
Probably you are dealing with Atonic Lacrimal Sac. In spite of this some times it is temporary due filling of the sac with contents decrease the tone of the sac. You should advice the patient to keep the sac evacuated for by doing lacrimal sac massage repeatedly and regain some sac muscles tone. if it does not work and your patient is young, go for conventional DCR it works well in these patients but if patient is over 65 years you can consider a DCT for the patient.
DR RC Gupta
GSVM Medical College, Kanpurwww.oculoplasticsindia.comExpert Comment:
DEAR DR. RAMNAIK,
From the history, it appears you are having a case of mucocele with internal fistula.you have not informed me about findings of syringing & probing which is important to know whether it is a communicating or non-communicating type of mucocele. you can also go for dacryocystography for documentation or even CT-DCG.SURGERY:Dacryocystorhinostomy (DCR) IF IT IS COMMUNICATING TYPE. COMMON - CANALICULO - DCR IF IT IS ENCYSTED MUCOCELE. EVEN DCR WITH INTERNAL PUNCTOPLASTY MAY ALSO BE TRIED.
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