Presentation
Two months history of swelling over medial canthus of right eye with associated epiphora.
Patient Data
There is a fluid density swelling in the region of the medial canthus of the right orbit on non-contrast images. Topical post-contrast images show normal opacification of the canaliculi with retention of contrast within the lacrimal sac, which appears distended with no contrast within the nasolacrimal duct. Findings are suggestive of nasolacrimal drainage apparatus obstruction at the level of the valve of Krause.
Case Discussion
This 15-year-old boy presented with gradual onset swelling in relation to the medial canthus of his right eye, which progressively enlarged in size over a 2-month period. This was associated with significant epiphora from the right eye. There was no previous history of trauma or surgery. No other underlying comorbidity was present besides occasional nasal congestion, which was seasonal.
Nasolacrimal drainage apparatus obstruction was suspected clinically, which was confirmed on CT after topical instillation of contrast.
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