Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T09:21:07.311Z Has data issue: false hasContentIssue false

An unusual case of conjunctival irritation and epiphora following external dacryocystorhinostomy

Published online by Cambridge University Press:  02 August 2011

P Mezzana*
Affiliation:
G B Bietti Eye Foundation, Rome, Italy
N Marabottini
Affiliation:
Ophthalmology Department, S Giovanni Addolorata Hospital, Rome, Italy
F Scarinci
Affiliation:
G B Bietti Eye Foundation, Rome, Italy
P Pasquini
Affiliation:
ACO S Filippo Neri Hospital, Rome, Italy
*
Address for correspondence: Dr Paolo Mezzana, IRCCS, Fondazione G.B. Bietti, Via Livenza, 3 00198, ROMA, Italy E-mail: [email protected]

Abstract

Objective:

The authors discuss a case of conjunctival irritation and epiphora in a patient who had undergone dacryocystorhinostomy three years earlier.

Method:

Case report, and a review of the world literature concerning lacrimal canalicular air regurgitation after dacryocystorhinostomy.

Results:

A 70-year-old woman, who used continuous positive airway pressure therapy during sleep, complained of epiphora and conjunctival irritation. She had undergone dacryocystorhinostomy three years earlier. Her right eye had an augmented tear meniscus, with a predominantly medial conjunctival irritation. Conjunctival irritation from lacrimal canalicular air regurgitation was diagnosed. White petrolatum and mineral oil ophthalmic ointment was prescribed, applied topically before sleeping. After one month of treatment, complete relief of symptoms was obtained.

Conclusion:

There is little current information on managing such patients. It is imperative to discuss this potential complication when considering nasolacrimal surgery in patients using continuous positive airway pressure therapy.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Behbehani, R, Mathews, MK, Sergott, RC, Savino, PJ. Nonarteritic anterior ischemic optic neuropathy in patients with sleep apnea while being treated with continuous positive airway pressure. Am J Ophthalmol 2005;139:518–21CrossRefGoogle ScholarPubMed
2Quinnell, TG, Smith, IE. Obstructive sleep apnoea in the elderly: recognition and management considerations. Drugs in Aging 2004;21:307–22CrossRefGoogle ScholarPubMed
3Kakkar, RK, Berry, RB. Positive airway pressure treatment for obstructive sleep apnea. Chest 2007;132:1057–72CrossRefGoogle ScholarPubMed
4Engleman, HM, Martin, SE, Douglas, NJ. Compliance with CPAP therapy in patients with sleep apnea/hypopnea syndrome. Thorax 1994;49:263–6CrossRefGoogle Scholar
5Harrison, W, Pence, N, Kovacich, S. Anterior segment complications secondary to continuous positive airway pressure machine treatment in patients with obstructive sleep apnea. Optometry 2007;78:352–5CrossRefGoogle ScholarPubMed
6Cannon, PS, Madge, SN, Selva, D. Air regurgitation in patients on continuous positive airway pressure (CPAP) therapy following dacryocystorhinostomy with or without Lester Jones tube insertion. Br J Ophthalmol 2010;94:891–3CrossRefGoogle ScholarPubMed
7Chang, NW, Foss, T, Chang, T, Chang, K, Barrett, M, Carney, J et al. Nasolacrimal reflux – a new clinical finding. J Allergy Clin Immunol 2006;117(S2):S166CrossRefGoogle Scholar