Lacrimal gland enlargement in Wegener's granulomatosis

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Abstract
Wegener's granulomatosis is characteriied by chronic, focal, necrotizingand granulomatous vasculitis, mainly affecting the upper respiratory tract, lungs and kidneys. Eye manifestations are common and occur in about 50% of cases of generalized Wegener's granulomatosis (Haynes et al., 1977). Since Straatsma (1957) it is believed that nasolacrimal duct obstruction, proptosis, involvement of eye musclesas well as the optic nerveare the result of granulomatous sinusitis that has invaded into the orbit, whereas focal vasculitis will produce conjunctivitis, episcleritis. scleritis, uveitis and granulomatous vasculitis of the retina and optic nerve. The cause of Wegener's granulomatosis has still largely remained obscure, although it is thought to be of autoimmune origin. A review of II cases of Wegener's granulomatosis studied at the Ophthalmological Department of the Frec University Hospital, Amsterdam and the Orbital Centre Amsterdam disclosed CT-documented lacrimal gland enlargement in seven patients. The patterns of ocular involvement are discussed.