Lacrimal caruncle

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Lacrimal caruncle
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Front of left eye with eyelids separated. Caruncula visible and labeled at left.
Details
System Eye
Identifiers
Latin caruncula lacrimalis
TA98 A15.2.07.049
TA2 6844
FMA 77672
Anatomical terminology

The lacrimal caruncle, or caruncula lacrimalis, is the small, pink, globular nodule at the inner corner (the medial canthus) of the eye. [1] It consists of tissue types of neighbouring eye structures. It may suffer from lesions and allergic inflammation.

Contents

Structure

The lacrimal caruncle is found at the medial canthus of the eye. [1] It consists of skin, hair follicles, sebaceous glands, sweat glands, accessory lacrimal tissue and other tissues that are present in the skin and accessory lacrimal glands. [1] [2] Its non-keratinized epithelium resembles the conjunctival epithelium. [2]

Clinical significance

Lesions

The lacrimal caruncle may have a lesion. [3] This can have any one of a number of causes, which may be difficult to diagnose. [3] Cancer is a rare cause. [3] [4] These lesions include papillomas and oncocytomas. [4]

Allergies

With ocular allergies, the lacrimal caruncle and the plica semilunaris of the conjunctiva may be inflamed and pruritic (itchy) due to histamine release in the tissue and tear film.

Other diagnoses

Sweat glands and oil glands are contained in the caruncle of the eye (lacrimal caruncle in medial canthus). As with all oil glands, lacrimal caruncles can become clogged, causing a pimple, whitehead, or pustule beneath the skin. Clogged oil and sweat glands in the caruncle can affect tear ducts. Treatment for dry eyes due to clogged glands includes refraining from rubbing the eyes and rinsing the eyes with clear water frequently during the day, either with clean hands or a spray faucet. Additionally, one can use a warm damp cloth on the eye, which will help the clogged pore to open up and release some pressure. Anti-bacterial eye drops may also be prescribed. If the pustules enlarge, an oral antibiotic may be prescribed. If lesions such as cysts form, they must be surgically drained; this operation is rarely necessary. [5] If it affects the tear sac it may be dacryocystitis.

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<span class="mw-page-title-main">Lacrimal sac</span> Upper, dilated end of the nasolacrimal duct

The lacrimal sac or lachrymal sac is the upper dilated end of the nasolacrimal duct, and is lodged in a deep groove formed by the lacrimal bone and frontal process of the maxilla. It connects the lacrimal canaliculi, which drain tears from the eye's surface, and the nasolacrimal duct, which conveys this fluid into the nasal cavity. Lacrimal sac occlusion leads to dacryocystitis.

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The plica semilunaris is a small fold of bulbar conjunctiva on the medial canthus of the eye. It functions during movement of the eye, to help maintain tear drainage via the lacrimal lake, and to permit greater rotation of the globe, for without the plica the conjunctiva would attach directly to the eyeball, restricting movement. It is the vestigial remnant of the nictitating membrane which is drawn across the eye for protection, and is present in other animals such as birds, reptiles, and fish, but is rare in mammals, mainly found in monotremes and marsupials. Its associated muscles are also vestigial. It is loose, thus eye movements are not restricted by it. Only one species of primate, the Calabar angwantibo, is known to have a functioning nictitating membrane.

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<span class="mw-page-title-main">Salivary gland tumour</span> Medical condition

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<span class="mw-page-title-main">Sebaceous carcinoma</span> Medical condition

Sebaceous carcinoma, also known as sebaceous gland carcinoma (SGc), sebaceous cell carcinoma, and meibomian gland carcinoma is an uncommon malignant cutaneous tumor. Most are typically about 1.4 cm at presentation. SGc originates from sebaceous glands in the skin and, therefore, may originate anywhere in the body where these glands are found. SGc can be divided into 2 types: periocular and extraocular. The periocular region is rich in sebaceous glands making it a common site of origin. The cause of these lesions in the vast majority of cases is unknown. Occasional cases may be associated with Muir-Torre syndrome. SGc accounts for approximately 0.7% of all skin cancers, and the incidence of SGc is highest in Caucasian, Asian, and Indian populations. Due to the rarity of this tumor and variability in clinical and histological presentation, SGc is often misdiagnosed as an inflammatory condition or a more common neoplasm. SGc is commonly treated with wide local excision or Mohs micrographic surgery, and the relative survival rates at 5 and 10 years are 92.72 and 86.98%, respectively.

<span class="mw-page-title-main">Syringocystadenoma papilliferum</span> Medical condition

Syringocystadenoma papilliferum is a rare non-malignant adnexal neoplasm that develops from apocrine or eccrine sweat glands and can be identified histologically by cystic, papillary, and ductal invaginations into the dermis lined by double-layered outer cuboidal and luminal high columnar epithelium and connected to the epidermis.

<span class="mw-page-title-main">Accessory visual structures</span> External parts of the eye including eyebrow, eyelid, and lacrimal apparatus

The accessory visual structures are the protecting and supporting structures (adnexa) of the eye, including the eyebrow, eyelids, and lacrimal apparatus. The eyebrows, eyelids, eyelashes, lacrimal gland and drainage apparatus all play a crucial role with regards to globe protection, lubrication, and minimizing the risk of ocular infection. The adnexal structures also help to keep the cornea moist and clean.

References

  1. 1 2 3 Okumura, Yuta; Takai, Yoshiko; Yasuda, Shunsuke; Terasaki, Hiroko (2017). "Bilateral lacrimal caruncle lesions". Nagoya Journal of Medical Science. 79 (1): 85–90. doi:10.18999/nagjms.79.1.85. ISSN   0027-7622. PMC   5346624 . PMID   28303065.
  2. 1 2 Miura-Karasawa, Maria; Toshida, Hiroshi; Ohta, Toshihiko; Murakami, Akira (27 April 2018). "Papilloma and sebaceous gland hyperplasia of the lacrimal caruncle: a case report". International Medical Case Reports Journal. 11: 91–95. doi: 10.2147/IMCRJ.S162528 . PMC   5927183 . PMID   29731668.
  3. 1 2 3 Santos, Arturo; Gómez-Leal, Alfredo (1994-05-01). "Lesions of the Lacrimal Caruncle: Clinicopathologic Features". Ophthalmology. 101 (5): 943–949. doi:10.1016/S0161-6420(94)31233-4. ISSN   0161-6420. PMID   8190485.
  4. 1 2 Kapil, Jyoti P.; Proia, Alan D.; Puri, Puja Kumari (May 2011). "Lesions of the Lacrimal Caruncle With an Emphasis on Oncocytoma". The American Journal of Dermatopathology . 33 (3): 227–235. doi:10.1097/DAD.0b013e3181d9b56d. ISSN   0193-1091. PMID   21522047. S2CID   22955802.
  5. Levy, J., Ilsar, M., Deckel, Y. et al. Lesions of the caruncle: a description of 42 cases and a review of the literature. Eye 23, 1004–1018 (2009). https://doi.org/10.1038/eye.2008.316

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