What is lacrimal gland prolapse?

The lacrimal gland, responsible in part for tear production, is normally tucked under the edge of the bony orbital rim in a space called the lacrimal fossa, located above the outer corner of the eye. The gland consists of two portions or lobes, the orbital lobe and the palpebral lobe. Sometimes the palpebral lobe can be seen under the eyelid when lifting the eyelid upward and looking downward.

A low-positioned lacrimal gland can leave a bulge above the outer corner of the upper eyelid.

What causes the tear gland to sag?

Lacrimal gland descent or prolapse is common and associated with normal aging. It is also seen in conjunction with a rare syndrome called blepharochalasis which consists of recurrent episodes of severe eyelid swelling. Trauma is another rare cause of this finding.

The gland may become more visible with aging as the skin becomes thinner and surrounding fat shrinks.

Not to be confused with

Lacrimal gland enlargement caused by inflammation or tumor. This should also not be confused with fatty pouches of the upper eyelids (steatoblepharon) which do not typically occur at the outer third of the upper lid where the lacrimal gland resides.

What you see in the mirror

A bulge above the outer corner of the upper eyelid.

Dr. brett kotlus cosmetic oculoplastic lacrimal prolapse