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 with 78% of patients being female and 89% unilateral.

Caused by obstruction of both of the outflow pathways, the proximal valve of Rosenmuller, and the distal valve of Hasner.

Early recognition and treatment of congenital dacryocystocele can prevent the recognised complications of respiratory compromise in neonates, infection, orbital displacement and astigmatism. The use of gentle digital massage as an early intervention in the neonatal period is advocated, and conservative measures may be sufficient in cases of uncomplicated dacryocystocele in 60% of cases.

Reported infectious complications of untreated dacryocystitis include preseptal cellulitis, orbital cellulitis, and even invasion of the ethmoidal cells.

Silva-Rosas et al., from the Clinical Hospital of University of Chile, reported a case of focal epilepsy as a late complication of congenital dacryocystocele ¹⁾.