Lacrimal (Tear System)

Dacryoadenitis

Dacryoadenitis involves the inflammation of the lacrimal gland and presents with symptoms like pain, tenderness and swelling of the inner eyelid. The inflammation can lead to infection causing preseptal or orbital cellulitis or lacrimal gland abscesses. Dacryoadenitis can occur with systemic diseases such as Sjogren’s, sarcoidosis, syphilis, TB, lymphoma, benign lymphoid hyperplasia, and herpes zoster. Treatment involves antibiotics and abscess drainage as needed.

Canaliculitis

The canaliculus is the channel in the inner eyelid that allows tears to pass and drain into the tear sac. Canaliculitis is the condition associated with inflammation caused by canaliculus infection. Symptoms include pain, swelling, tenderness and treatment includes penicillin irrigation. This condition usually impacts patients over 40 years of age and can result in chronic inflammation.

Dacryocystitis

Dacryocystitis involves an infected nasolacrimal sac caused by a blockage of the nasolacrimal duct. Symptoms revolve around a swollen lacrimal sac that is tender, red, and producing a discharge. If severe, treatment involves surgery to create a new tear duct. These are created using silicone tubes placed in the lacrimal system.

Acute Dacryocystitis

Acute dacryocystitis is caused by a nasolacrimal duct obstruction causing drainage issues from the lacrimal sac to the nose. Tear stasis causes a secondary infection and edema results. Treatment may include warm compresses, antibiotics, and abscess drainage. Many patients need tear duct surgery, dacryocystorhinostomy (DCR), after the acute infection subsides.

Chronic Dacryocystitis

Chronic dacryocystitis is caused by a distended lacrimal sac and suppurative discharge from the punctum. Usually, this condition requires a dacryocystorhinostomy (DCR).