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Dacryolith formation around an eyelash retained in the lacrimal sac
Abstract:
A dacryolith was discovered in the lacrimal sac during a dacryocystorhinostomy for chronic dacryocystitis in which there was mucocele formation. Morphological examination confirmed the presence of an eyelash at the centre of the stone and electron microscopy demonstrated the presence of fungi (Candida sp.) in a matrix which was of markedly vairable morphology. The mechanism by which a hair enters the punctum and passes along the canaliculus may be attributed to the step-like pattern of ridges on the surface of a hair. The directional nature of these ridges dictates preferential movement towards the root end of the hair and prevents movements in the opposite direction.
Insights
A dacryolith, a stone in the tear sac, was found to contain an eyelash and fungi. Hair
Area of Science:
- Ophthalmology
- Pathology
Background:
- Chronic dacryocystitis can lead to mucocele formation in the lacrimal sac.
- Dacryocystorhinostomy is a surgical procedure to treat blocked tear ducts.
Observation:
- A dacryolith was identified within the lacrimal sac during surgery for chronic dacryocystitis.
- The dacryolith contained an eyelash at its core.
- Fungal elements (Candida sp.) were observed within the dacryolith matrix.
Findings:
- The dacryolith's matrix exhibited variable morphology.
- Microscopic ridges on hair shafts facilitate unidirectional movement into the punctum and canaliculus.
- This mechanism explains how hairs can enter the tear drainage system.
Implications:
- Understanding dacryolith composition aids in diagnosing and managing tear duct obstructions.
- Identifies a potential pathway for foreign body migration into the lacrimal system.
- Highlights the role of fungal infections in dacryolith formation.