Wolfring Dacryops

Abstract

The formation of a ductal cyst appears to require two successive, inter-related events. The first is an ongoing active secretory process, and the second is an occlusion of the duct. The sequential occurrence of these two events is forwarded as the explanation of dacryops formation. Excision using a conjunctival approach is recommended. A small strip of tarsal border should be removed with the cyst to prevent cyst rupture. The excretory ducts of the Wolfring glands exit through this area.

Dacryops

“…The original theory postulated that inflammation or trauma blocked excretory ductules, leading to a mechanical dilation due to subsequent build up of secretions. 2,4 But this was not supported experimentally; obliteration of lumina caused gland atrophy and cessation of secretion with no dilation. 2 Most histological studies describe mild inflammation of the cyst wall, which is the basis for the hypothesis that a combination of periductal inflammation, hypersecretion, and impaired neuromuscular contractility of the ductules cause cyst formation.…”

“…2,4 But this was not supported experimentally; obliteration of lumina caused gland atrophy and cessation of secretion with no dilation. 2 Most histological studies describe mild inflammation of the cyst wall, which is the basis for the hypothesis that a combination of periductal inflammation, hypersecretion, and impaired neuromuscular contractility of the ductules cause cyst formation. 1,4 Additionally, Weatherhead 2 suggested that an osmotic gradient produced by concentrated IgA in cystic fluid is a contributory factor for the cyst formation.…”

“…2 Biochemical analysis of the cystic fluid in 2 studies involving the accessory lacrimal glands showed higher IgA values in the cyst fluid compared with serum, suggesting its presence was not due to a passive diffusion alone into the cyst, but that an active secretory process is occurring, as is supported by our ultrastructural findings. 2,6 The mechanism leading to cyst formation is multifactorial. Our results support the hypothesis that chronic inflammation with a subsequent immune response activates the nearby plasma cells to produce IgA.…”

Apocrine secretion in lacrimal gland cysts (dacryops): a common but underrecognized phenomenon

“…The pathogenesis of lacrimal gland cysts is believed to be related to periductal or conjunctival inflammation or trauma, which results in lacrimal gland hypersecretion and damage to duct walls with secondary obstruction and subsequent dilatation. Trachoma was suggested to be a predisposing factor in some cases 10 . Rarely, dacryops may occur simultaneously with pleomorphic adenoma or with some other neoplasms that may cause cystic dilatation of lacrimal ducts 11 …”

“…Trachoma was suggested to be a predisposing factor in some cases. 10 Rarely, dacryops may occur simultaneously with pleomorphic adenoma or with some other neoplasms that may cause cystic dilatation of lacrimal ducts. 11 Apocrine differentiation in lacrimal gland cysts is not usually mentioned as a common feature.…”