Primary powered endoscopic dacryocystorhinostomy is an effective modality in the management of acute dacryocystitis and lacrimal abscess, and result in rapid resolution of the disease.

This study presents the largest series to date (n = 200 lacrimal sacs) exclusively on changes in lacrimal drainage-associated lymphoid tissue in human chronic dacryocystitis. This study could be the starting point for further exploration into the molecular biology, immunological implications, and possible implications of LDALT derangements on etiopathogenesis of primary acquired nasolacrimal duct obstruction.

This study aims to describe the clinicopathological features and outcomes of patients who underwent orbital exenteration at a tertiary eye care center in south India. Retrospective chart reviews were performed on all patients undergoing orbital exenteration from January 1999 to December 2012. Parameters recorded include demographic data, clinical presentations, past medical or surgical interventions, exenteration notes, histopathological diagnosis, adjunctive treatment, follow-up examination findings, recurrences, complications, and their management. Orbital exenteration was performed on 119 orbits of 119 patients over a 14-year period. The mean age was 48.9 years (range 1-82 years). The indications were malignancies in 90.7 % (108/119), while 9.3 % (11/119) of cases were exenterated for non-malignant indications. Among the malignancies, the commonest tissue of origin was conjunctiva, noted in 45.4 % (49/108), followed by eyelids (25.9 %, 28/108), orbit (19.4 %, 21/108), and intraocular tissues (9.3 %, 10/108). The commonest malignancies noted in this series were an extensive ocular surface squamous neoplasia (OSSN) (44.4 %, 48/108) and sebaceous gland carcinoma of eyelids with an orbital involvement (18.5 %, 20/108). Extensive fungal granuloma (mucormycosis-4, aspergillosis-4) was the commonest (81.8 %, 9/11) indication among the non-malignant group. All complications were wound related, and none had a recurrence at a mean follow-up of 12.8 months. Extensive orbital involvement with OSSN and SGC were the commonest indications for exenteration. There is a need of creating awareness among general ophthalmologists in specific geographical regions regarding early diagnosis, standardized protocols of management, and appropriate referral.

Primary lacrimal sac melanoma is an extremely rare clinical entity with fewer than 25 cases reported in the literature. We present a well-documented case of lacrimal sac melanoma with anterior lacrimal crest infiltration and discuss the clinical, radiological and histopathological features along with surgical challenges and treatment.