Lymphangiectasia haemorrhagica conjunctivae.

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Lymphangiectasia haemorrhagica conjunctivae.

Postby patoco » Thu Sep 21, 2006 8:03 pm

Lymphangiectasia haemorrhagica conjunctivae.

Lochhead J, Benjamin L.
Department of Ophthalmology, St Bartholomew's Hospital, London, UK.

PURPOSE: To re-describe a condition that has not been mentioned in the literature for more than four decades and to outline a new method of treatment of the pathology using an argon laser. METHODS: Nine patients were identified over a 2 year period who fitted a clinical picture consistent with the features of lymphangiectasia haemorrhagica. Three were treated for frequent recurrent haemorrhages with a newly developed technique using the argon laser and followed for up to 2 years. RESULTS: None of the three treated patients has had a recurrence of the condition to date. In the six untreated patients the condition resolved spontaneously after repeated attacks over between 8 months and 8 years. CONCLUSIONS: Lymphangiectasia haemorrhagica conjunctivae is probably more common than expected and may resolve spontaneously, but is readily amenable to treatment with the argon laser if attacks become frequent, uncomfortable or unsightly.

PMID: 9850253 [PubMed - indexed for MEDLINE] ... med_docsum


Idiopathic conjunctival lymphangiectasia

Spraul CW, Buchwald HJ, Lang GK.
Universitats-Augenklinik, Ulm.

PATIENT: A 41-year-old male was evaluated for multiple yellowish cysts on the temporal bulbar conjunctiva of his right eye. These cysts have spontaneously developed over a period of one week, have been punctuated, and recurred one week later in an even greater number. The patient's ophthalmologic and medical history were normal. Complete excision of the largest cysts and marsupialization of the smaller cysts were performed. Histologic features of the excised cysts were consistent with lymphangiectasia and displayed dilated lymphatic channels.

CONCLUSION: Conjunctival lymphangiectasia is a benign condition of unknown etiology. It has been observed with many underlying diseases as well as spontaneously and the dilated lymphatic channels can secondarily become hemorrhagic (Hemorrhagic lymphangiectasia of the conjunctiva). Simple excision and/or marsupialization are therapeutic options.

PMID: 9333668 [PubMed - indexed for MEDLINE] ... ds=9333668


Lymphangiectasia haemorrhagica conjunctivae.

From EyeOrbit - link no longer available

Not infrequently we see in the scleral conjunctiva small bright vesicles, arranged in a row like a string of pearls, or even joined so as to form longer sausage-like swellings. Here we have to do with dilated lymph-vessels that are filled with a clear liquid ( lymphangiectasiae ). These occur both in inflammation of the conjunctiva and also when the conjunctiva is perfectly healthy. “ from Fuchs’s Textbook of Ophthalmology by Duane: p. 222, 6th edition, 1919, Lippincott.

The author was unable to find any mention of lymphangiectasia hemorrhagica conjunctivae in this classic Textbook of Ophthalmolgy. Incidentally, this single-volume classic of ophthalmology literature should be read from cover to cover by all ophthalmologists. Its clinical pearls are endless - many of them are applicable even now. Additionally, its style makes for enjoyable reading.

The author’s search of Thiel’s Atlas der Augenkrankheiten - 6th edition - failed to reveal mention of lymphangiectasia of the bulbar conjunctiva. Although the original edition of this arguably foremost hard-print eye atlas is in German, there is a two volume translation in English that should be available to all ophthalmologists - either in a personal library or in a medical school library.

I. Abnormal diffuse enlargement of lymphatics appears clinically as chemosis. Localized, dilated lymphatics appear clinically as a cyst or series of cysts, the latter commonly in the area of the interpalpebral fissure.

II. With diffuse involvement the cause generally is not known.

III. In the localized variety the dilated lymphatics generally are obstructed secondarily by an old scar, a pinguecula or some other conjunctival pathology.

IV. Histologically the lymphatic vessels are dilated abnormally.

Lymphangiectasia hemorrhagica conjunctivae:

I. The condition is characterized by a connection between a blood vessel and a lymphatic so that the latter is permanently or intermittently filled with blood. II. The cause is not known. “ from Yanoff and Fine: Ocular Pathology, pages 236 - 237, 1975, Harper & Row.


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