Name of the Condition

• Common Name(s): Dacryolith
• Medical Term: Dacryolithiasis of the left lacrimal passage

Summary

Dacryolithiasis is a condition characterized by the formation of tear stones or dacryoliths within the lacrimal system. These stone-like deposits can obstruct tear flow, leading to discomfort and other symptoms.

Causes

• The exact cause of dacryolith formation is not well understood but may involve:
  • Accumulation of debris in the tear duct
  • Inflammation of the lacrimal system
  • Changes in tear composition

Risk Factors

• Age: More common in middle-aged to older adults
• Chronic inflammation or infections of the eyes or tear ducts
• History of recurrent dacryocystitis

Symptoms

• Tearing (epiphora)
• Swelling and tenderness near the inner corner of the eye
• Occasional discharge from the eye
• Pain or discomfort around the eyes

Diagnosis

• Physical examination, including inspection of the eye area
• Imaging tests like dacryocystography or orbital ultrasound to visualize stone presence
• Endoscopic examination of the lacrimal passage

Treatment Options

• Medications: To manage associated infections or inflammation
• Lacrimal duct probing and irrigation: To remove obstructions
• Surgery (Dacryocystorhinostomy or DCR): For severe cases to create a new drainage pathway
• Lacrimal duct stenting: To keep the duct open after clearing obstructions

Prognosis and Follow-Up

• With appropriate treatment, the prognosis is generally good.
• Regular follow-ups are crucial for monitoring the lacrimal system and preventing recurrence, especially after surgical procedures.

Complications

• Untreated dacryoliths can lead to chronic tear duct inflammation or infection (dacryocystitis).
• Possible damage to the lacrimal duct if obstructions persist.

Lifestyle & Prevention

• Good eye hygiene might reduce infection risk.
• Early treatment of eye infections to prevent duct complications.
• Regular medical check-ups if there is a history of lacrimal system issues.

When to Seek Professional Help

• Persistent tearing or eye discharge
• Pain or swelling near the eye
• Recurrence of eye infections

Additional Resources

• American Academy of Ophthalmology (AAO)
• Mayo Clinic
• Patient support groups or forums for individuals with dacryolithiasis

Tips for Medical Coders

• Ensure specificity by coding the correct side; H04.512 specifies the left lacrimal passage.
• Verify if additional codes are needed for associated conditions like infections (e.g., dacryocystitis).
• Avoid miscoding by distinguishing between unilateral and bilateral conditions.