Scollo Paolo, Davies Rhys, O'Donovan Dominic, Rene Cornelius
Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, UK
Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, UK.
BMJ Case Rep. 2021 May 7;14(5):e240942. doi: 10.1136/bcr-2020-240942.
A 35-year-old woman underwent left external dacryocystorhinostomy (DCR) following a recent bout of left acute dacryocystitis. She had a right DCR 14 years earlier. Her relatively young age of presentation prompted suspicion of secondary nasolacrimal duct obstruction and, although the left lacrimal sac appeared macroscopically normal peroperatively, a lacrimal sac biopsy was taken. Histopathology revealed florid chronic inflammation, with abundant granular brown pigment and polarisable crystals suggestive of an exogenous material in the lacrimal sac mucosa compatible with mascara. After initial improvement, her epiphora has recurred 1-year postoperatively, but her ocular discharge has resolved. Mascara-induced conjunctival pigmentation is well established. However, there are very few published reports of nasolacrimal duct obstruction due to mascara. Since cosmetic application of mascara and kohl eyeliner is widespread, patients and practitioners should be aware of their potential to migrate into the lacrimal apparatus and cause chronic inflammation with secondary nasolacrimal duct obstruction.
一名35岁女性在近期患左侧急性泪囊炎后接受了左侧外路泪囊鼻腔吻合术（DCR）。她14年前曾接受过右侧DCR。她相对年轻的发病年龄引发了对继发性鼻泪管阻塞的怀疑，尽管术中左侧泪囊在肉眼下看起来正常，但还是进行了泪囊活检。组织病理学显示有明显的慢性炎症，伴有大量颗粒状棕色色素和可极化晶体，提示泪囊黏膜中有与睫毛膏相符的外源性物质。术后初期症状有所改善，但术后1年她又出现了溢泪症状，不过眼部分泌物已消失。睫毛膏引起的结膜色素沉着已得到充分证实。然而，关于睫毛膏导致鼻泪管阻塞的 published reports 非常少。由于睫毛膏和眼线笔的美容应用很广泛，患者和从业者应该意识到它们有可能进入泪器并导致慢性炎症及继发性鼻泪管阻塞。 （注：原文中“published reports”直译为“已发表的报告”，放在这里表述稍显生硬，可根据语境灵活调整，比如“公开报道”等，但按要求需保留原文表述。）
