학술논문

Lacrimal Duct Obstruction and Infection Associated with Non-Traumatic Corneal Perforation: A Case Series
Document Type
article
Source
International Medical Case Reports Journal, Vol Volume 15, Pp 313-322 (2022)
Subject
corneal perforation
lacrimal duct obstruction
lacrimal duct infection
dacryocystitis
purulent discharge
dry eye
case series
Medicine (General)
R5-920
Language
English
ISSN
1179-142X
Abstract
Keisuke Nitta, Ryo Mukai, Daisuke Todokoro, Hideo Akiyama Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Gunma, JapanCorrespondence: Keisuke Nitta, Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan, Tel +81-27-220-8338, Fax +81-27-220-3841, Email keisuke-nitta@gunma-u.ac.jpPurpose: To report a case series of lacrimal duct obstruction and infection associated with non-traumatic corneal perforation.Case Series: This study included 6 eyes in 6 patients with non-traumatic corneal perforation treated between April 2019 and March 2021. All 6 cases were associated with lacrimal duct obstruction and infection. Purulent discharge caused by lacrimal duct infection was observed in all 6 patients (100%). However, three of the 6 patients (50%) did not show purulent discharge at initial examination and lacrimal duct obstruction was therefore not initially recognized. Dry eye was observed in five of the 6 patients (83%) and may have caused corneal deterioration, increasing susceptibility to perforation. Further, dry eye masks symptoms of lacrimal duct obstruction and infections, such as epiphora and regurgitation of purulent discharge, making the association with lacrimal duct obstruction and infection difficult to determine. All patients were treated for both corneal perforation and lacrimal duct disease, and conditions improved, with no recurrence of either corneal perforation or lacrimal duct disease.Conclusion: In patients with a combination of lacrimal duct disease and corneal perforation, treatment of both diseases resulted in stabilization of patient condition. Dry eyes may mask symptoms of lacrimal duct diseases, such as epiphora and purulent discharge, and lacrimal duct disease may thus be underdiagnosed.Keywords: corneal perforation, lacrimal duct obstruction, lacrimal duct infection, dacryocystitis, purulent discharge, dry eye, case series