Contributor: William Charles Caccamise, Sr, MD, Retired Clinical Assistant Professor of Ophthalmology, University of Rochester School of Medicine and Dentistry
*Dr. Caccamise has very generously shared his images of patients taken while operating during the "eye season" in rural India as well as those from his private practice during the 1960's and 1970's. Many of his images are significant for their historical perspective and for techniques and conditions seen in settings in undeveloped areas.
Chronic dacryocystitis with draining fistula
This female patient is a candidate for a dacryocystorhinostomy. Observe the peculiar linear reflexes surrounding the opening of the fistula. Similar but much less conspicuous linear reflexex are seen in the previous monocular photo of a draining fistula. As an added note: a vast majority of patients who have tear drainage problems are females over 40 years of age.
Under appropriate magnification, a stream can be easily seen as it flows downward from the summit of the enlarged , chronically inflamed tear sac OS. A dacryocystorhinostomy was performed to correct the problem.
Finger pressure on the bump over the left lacrimal sac caused a thick mucoid fluid to ooze from the inferior punctum. The chronic dacryocystitis was cured through a dacryocystorhinostomy. Unlike most of the patients with dacryocystitis, this patient was a male.
Ruptured chronic dacryocystitis
Spontaneous fistulization through the skin overlying the lacrimal sac at times will satisfy the patient. However,in this case the treatment was a dacryocystorhinostomy with a good result.
Chronic dacryocysitis with abscess formation
A case of chronic dacryocystitis in an older female patient who as a further complication developed a pus-filled abscess of the lacrimal sac. Treatment involved intensive antibiotic therapy followed by a dacryocystorhinostomy.
Chronic dacryocystitis: pre-dacryocystorhinostomy
The patient can be identified as a Hindu by the mark above the glabella, the red in the frontal parting of the hair, her jewelry, and her garb with its colors. Red and yellow are favorite Hindu colors while green is a favorite Muslim color.
abscess of tear sac
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.