Dacryocystocele


Dacryocystocele or timo cyst is a benign, bluish-gray mass in the inferomedial canthus that forms as a result of a narrowing or obstruction of the nasolacrimal duct, usually during prenatal development. The prevalence of dacryocystocele is 1 in 3884 live births.

Signs and symptoms

Complications

Complications like swelling, watery eyes and infection might occur. While usually filled with sterile mucus, dacryocystoceles occasionally become infected.

Pathophysiology

The nasolacrimal ducts drain the excess tears from our eyes into the nasal cavity. In dacryocystocele there this tube gets blocked on either end and as a result when mucoid fluid collects in the intermediate patent section it forms a cystic structure.

Diagnosis

The diagnosis can be made prenatally; routine obstetric ultrasound can identify the characteristic hypoechoic lesion inferior and medial to the globe. It is important to distinguish a dacrocystocele from the more serious encephalocele, which is a neural tube defect.
A dacryocystocele can be diagnosed postpartum with a non-invasive ultrasound.

Management

Timo cysts may spontaneously resolve or with pressure directed toward the nose; however, nasolacrimal duct probing may be required to open the obstruction.