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Lymphoma involving the lacrimal gland is rare. Most of the cases are unilateral at presentation. In this case, we present the diagnostic evaluation of a patient with bilateral lacrimal gland lymphoma. At presentation, the patient had inferomedial eccentric proptosis of the right eye. The patient also had limitation in the upper and lateral gaze in this eye. On magnetic resonance imaging, a mass was detected not only in the right but also in the left eye corresponding to the area of the lacrimal gland. Excisional biopsy was performed in the right eye with lateral orbitotomy approach. Histopathological examination revealed extranodal marginal zone lymphoma involving the lacrimal gland. No concurrent systemic lymphoma was detected during systemic evaluation of the patient. The patient was directed to the oncology department for systemic treatment planning. In conclusion, bilateral involvement is rare in lacrimal gland diseases but it can show severe diseases like lymphoma.

Objectives: To compare the outcomes of external dacryocystorhinostomy (DCR) and transcanalicular multidiode dacryocystorhinostomy (TC-DCR) operations in our clinic. Materials and Methods: This retrospective study included patients diagnosed with acquired nasolacrimal duct obstruction. The results of external DCR surgery performed in 15 eyes of 15 patients were compared with the results in 15 eyes of 13 patients who underwent TC-DCR surgery. The patients with external DCR were followed for an average of 9.7±3.2 months, and the cases that underwent TK-DSR were followed for an average of 8.3±2.9 months. Results: The surgical success rate was 53.3% in patients with TK-DCR, while it reached 87% in cases with external DCR. Mean operative time was 50.0±2.5 minutes in external DCR group and 30.0±2.0 minutes in TK-DCR group. There was no significant complication during operations in both groups. Conclusion: In dacryostenosis surgery, external DCR is the golden standard with high success rates. Even though success rate of TCDSR is less than that of external DSR, no need of skin incision, less damage to the lacrimal pump system, less bleeding, and a shorter duration of the operation are the main advantages of this method. (Turk J Ophthalmol 2014; 44: 31-4)