Congenital lacrimal sac mucoceles

Seven infants had tense, blue-gray swellings inferior to the medial canthal tendon with otherwise normal-appearing eyelids and puncta. All lacrimal sacs transilluminated and A-scan ultrasonography performed in one case demonstrated a nonloculated cystic cavity. Four (57%) infants had uncomplicated mucoceles. One was treated with massage, and has remained asymptomatic for 14 months. The other three were cured with a single probing and irrigation of the entire lacrimal system. Three (43%) infants had developed erythema of the tissues overlying the swollen lacrimal sacs by the time of referral. Because none of the mucoceles could be decompressed by massage, prompt probing and irrigations were performed in each case. Cultures from the aspirates of all three sacs yielded Staphylococcus organisms. In contrast to the uncomplicated cases, two patients developed recurrences that necessitated additional treatment.