Pathology of Lacrimal Organs

The lacrimal apparatus is responsible for producing, distributing, and draining tears, thereby maintaining a healthy ocular surface and protecting the eye from infection and environmental injury. Its diseases may affect the lacrimal gland, accessory glands, eyelids and puncta, canaliculi, lacrimal sac, or nasolacrimal duct. The major pathological groups include congenital abnormalities, infectious and inflammatory disorders, teardrainage obstruction, and benign or malignant tumours. Common clinical presentations are excessive tearing (epiphora), pain, swelling near the medial canthus or upper eyelid, discharge, and dry-eye symptoms. This review summarizes the anatomy, classification, causes, pathogenesis, clinical features, diagnostic methods, and principles of management of important lacrimal disorders. Particular attention is given to dacryoadenitis, dacryocystitis, nasolacrimal duct obstruction, congenital dacryocystocele, and lacrimal gland and sac tumours. Early recognition is important because uncomplicated disease is often treatable, whereas orbital infection and malignant lesions may threaten vision or life.