[Lymphatic congestion of the conjunctiva after pre-auricular lymph node excision]

A 68-year-old woman presented with massive congestion of lymphatic vessels of temporal inferior conjunctiva two months after extirpation of the parotic gland for an aciniform epithelioma on the same side. Clinical findings of the right and left eye were unremarkable otherwise. The congestion resolved spontaneously.

Patent Blue 2.5% was injected into the subconjunctiva in 5 mm distance of the limbus. The superior conjunctiva revealed a normal circular pattern of lymphatic vessels. In the temporal inferior conjunctiva massively congested lymphtic vessels could be demonstrated. This area is normally drained by the regional lymphnodes now interrupted by the surgery.

The individual anatomy of the lymphatic vessels may be of significance also in filtering surgery. Especially radial conjunctival cuts may interrupt the lymphatic vessels. The regional lymphatic drainage from the temporal inferior conjunctiva is blocked by massive surgery of the parotic gland.