A 77-year-old female patient who had been treated for glaucoma for many years was referred to an outpatient clinic to extend the diagnostic work-up because of rapidly deteriorating vision despite anti-glaucoma treatment. During the visit, in addition to characteristic ophthalmic symptoms, behavioral and orientation disturbances were found, which raised a suspicion of Foster Kennedy syndrome and prompted the examining physician to refer the patient for an urgent brain scan. A computed tomography examination revealed the presence of focal lesions. Rapid diagnosis enabled immediate transfer of the patient to a neurosurgical center for further treatment.

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Dacryocystectomy is a procedure that involves complete surgical extirpation of the lacrimal sac. It was first described by Woolhouse in 1724 and became the gold standard for the management of lacrimal system obstruction and dacryocystitis before the advent of dacryocystectomy. Many minimally invasive methods are currently available to treat lacrimal disorders, but there are several specific indications for dacryocystectomy, such as malignant lacrimal sac tumors. Generally, the procedure is performed under local anesthesia, which avoids risks that are associated with general anesthesia or sedation in ailing or elderly patients. Dacryocystectomy can also also avoid skin scars. In 2013, Shams and Selva were the first to perform endoscopic dacryocystectomy. This article discusses indications, contraindications, goals, techniques, and complications of dacryocystectomy.

Przewlekłe i nawracające zapalenie woreczka łzowego może mieć nietypowe przyczyny i niekiedy wymaga szerokiej diagnostyki. H i g H l i g H t s Chronic and recurrent dacryocystitis may have atypical underlying reasons, therefore, in some cases, a wide range of diagnostic tests is needed.

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