Abstract
Purpose
To determine the incidence and presenting features of congenital dacryocystocele in the United Kingdom. To report on those cases complicated by dacryocystitis, respiratory compromise, and the treatment undertaken.
Methods
A prospective observational study of cases of congenital dacryocystocele presenting in the United Kingdom between September 2014 and October 2015. Infants <3 months of age presenting with a cystic swelling in the medial canthal area were included. Cases were identified via the British Ophthalmology Surveillance Unit (BOSU) reporting system.
Results
A total of 49 cases were reported during the study period. This gives an incidence of 1 in 18 597 live births. There was a 71% response rate to the questionnaire. The average age at presentation was 16.94 days. Dacryocystoceles were unilateral in 91% of cases. Dacryocystitis was a complicating factor in 49% of patients and 17% had respiratory distress. Uncomplicated dacryocystocele responded well to conservative measures in 86%. Surgical intervention was required in 23% of patients. Those cases complicated by dacryocystitis (29%) and nasal obstruction (17%) were more likely to require surgical intervention compared to those with dacryocystocele alone (14%). Digital massage appears to reduce the likelihood of requiring surgical intervention. The mean time to resolution was 19 days.
Conclusions
Congenital dacryocystocele is a rare presentation in the United Kingdom. Dacryocystitis and respiratory compromise commonly complicate a dacryocystocele. The use of digital massage as an early intervention is advocated and conservative measures may be sufficient in cases of uncomplicated dacryocystocele.
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Acknowledgements
We thank the consultant ophthalmologists who contributed to this study through reporting cases of congenital dacryocystocele. We thank those who took the time to repeat the initial and follow-up questionnaire. We thank the Children and Young Peoples Research Network for contributing funding to assist in the carrying out of this study. We acknowledge the role of the British Ophthalmological Surveillance Unit, particularly Mr Barny Foot, the scientific coordinator for BOSU and the contributions of Mrs Tina McDonald who provided secretarial assistance.
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Davies, R., Watkins, W., Kotecha, S. et al. The presentation, clinical features, complications, and treatment of congenital dacryocystocele. Eye 32, 522–526 (2018). https://doi.org/10.1038/eye.2017.235
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DOI: https://doi.org/10.1038/eye.2017.235
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