The Importance of Clinicians Reviewing CT Scans in Suspected Lacrimal Gland Disease Causing Eyelid Swelling, Even if Radiologists Previously Interpreted them as Normal

PURPOSE To highlight the importance of deliberate evaluation of the lacrimal gland during routine orbital imaging by both radiologists and clinicians, which may avoid delays in diagnosis of eyelid swelling related to lacrimal gland disease. METHODS We present four cases referred to a tertiary ophthalmic plastic and orbital centre for assessment of chronic upper eyelid swelling of unknown aetiology. All four cases had been investigated with orbital CT imaging, reported to be normal by consultant radiologists. RESULTS Careful review of existing imaging provided valuable information concerning the lacrimal gland and helped identify a pathological cause in all four cases. CONCLUSIONS Lacrimal gland disease can be missed radiologically without evaluation of coronal as well as standard axial orbital imaging. Clear communication with the radiologist as well as personally reviewing scans can avoid such pitfalls.