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Dacryoadenitis, Dacryocystitis, and Canaliculitis

  • David R. JordanEmail author
  • Bazil Stoica
Chapter
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Abstract

Dacryoadenitis may be infectious or non-infectious in etiology (non-specific orbital inflammation of the lacrimal gland), present in a similar fashion and may be difficult to distinguish from one another in the early phase. Dacryocystitis commonly presents with tearing, redness, swelling and a tender mass over the nasolacrimal crest area and generally has a well-recognized clinical presentation. Intermittent episodes of tearing that may be very severe at times secondary to dacryocystic retention and/or a dacryolith may be more difficult to recognize. Canaliculitis often presents with recurrent discharge despite multiple antibiotic drops. A “pouting punctum” and expression of canaliculiths helps confirm the clinical diagnosis. This chapter will review each entity and provide clinical clues to help diagnose each more readily

Keywords

Dacryoadenitis Dacryocystocele Amniotocele Amniocele Dacryocystitis Dacryocystic retention Dacryolith Canaliculitis Canaliculith 

Suggested Readings

  1. 1.
    Rootman J, Robertson W, Lapoint JS. Orbital inflammatory diseases. In: Rootman J, editor. Diseases of the orbit: a multidisciplinary approach, chapt 12. Philadelphia: Lippincott; 2003. pp 455–459.Google Scholar
  2. 2.
    Goold LA, Madge SN, Au A, et al. Acute suppurative bacterial dacryoadenitis: a case series. Br J Ophthalmol. 2013;97(6):735–8.CrossRefGoogle Scholar
  3. 3.
    Lacrimal gland tumor study group. An epidemiological survey of lacrimal fossa lesions in Japan: number of patients and their sex ratio by pathological diagnosis. Jpn J Ophthalmol. 2005;49(5):343–8.CrossRefGoogle Scholar
  4. 4.
    Mawn LA, Sanon A, Conlan MR, et al. Pseudomonas dacryoadenitis secondary to a lacrimal ductile stone. Ophthal Plas Reconstr Surg. 1997;13:135–8.CrossRefGoogle Scholar
  5. 5.
    Tomita M, Shimmura S, Tsubota K, et al. Dacryoadenitis associated with acanthamoeba keratitis. Arch Ophthalmol. 2006;124:1239–42.CrossRefGoogle Scholar
  6. 6.
    Toledano N, Tit-Liviu Stoica B, Genol Saavedra I, et al. Tuberculous dacryoadenitis unveils HIV infection. Can J Ophthalmol. 2013;48(5):128–30.CrossRefGoogle Scholar
  7. 7.
    Nieto JC, Kim N, Lucarelli MJ. Dacryoadenitis and orbital myositis associated with Lyme disease. Arch Ophthalmol. 2008;126(8):1165–6.CrossRefGoogle Scholar
  8. 8.
    Mombaerts I. Non-infectious orbital inflammation. In: Fay A, Dolman PJ, editors. Diseases and disorders of the orbit and ocular adnexa, chapt 11. Elsevier; 2017. pp 185–217.Google Scholar
  9. 9.
    Lu W, Rootman DB, Berry JL, et al. Methicillin resistant Staphyloccous aureus dacryoadenitis. JAMA Ophthalmol. 2014;132(8):993–5.CrossRefGoogle Scholar
  10. 10.
    Ostri C, Heegaurd S, Prause JU. Sclerosing Wegener’s Granulomatosis in the orbit. Acta Ophthalmol. 2008;86(8):917–20.CrossRefGoogle Scholar
  11. 11.
    Rootman J, McCarthy M, White V, et al. Idiopathic sclerosing inflammation of the orbit. A distinct clinicopathologic entity. Ophthalmology. 1994;101(3):570–84.CrossRefGoogle Scholar
  12. 12.
    Kiratli H, Sekerogly MA, Soylemezoglu F. Unilateral dacryoadenitis as the sole presenting sign of Wegener’s Granulomatosis. Orbit. 2008;86(8):917–20.Google Scholar
  13. 13.
    Soheilian M, Bagheri A, Aletaha M. Dacryoadenitis as the earliest presenting manifestation of systemic Wegener’s Granulomatosis. Eur J Ophthalmol. 2002;12(3):241–3.CrossRefGoogle Scholar
  14. 14.
    Liu C-H, Ma L, Ku W-J, et al. Ilateral idiopathic sclerosing inflammation of the orbit: report of 3 cases. Chang Gung Med J. 2004;27(10):758–65.PubMedGoogle Scholar
  15. 15.
    McNab AA. Orbital inflammation in Churg-Strauss syndrome. Orbit. 1998;17(3):203–5.CrossRefGoogle Scholar
  16. 16.
    Berry-Brincat A, Rose GE. Idiopathic orbital inflammation:a new dimension with the discovery of immunoglobulin G4-related disease. Curr Opinion Ophthalmol. 2012;23(5):415–9.CrossRefGoogle Scholar
  17. 17.
    Pimpha O, Vahdani K, Kim D. Bilateral idiopathic dacryoadenitis associated with bony erosions mimicking lacrimal gland malignancy. Can J Ophthalmol. 2018;53:e83–4.CrossRefGoogle Scholar
  18. 18.
    Shinder R, Nasser QJ, Brejt S, Guttman J, et al. Idiopathic inflammation of the orbit and contiguous structures. Ophthal Plast Reconstr Surg. 2012;28:e82–5.CrossRefGoogle Scholar
  19. 19.
    Tang Sx, Lim RP, Al-Dahmash S et al. Bilateral lacrimal gland disease: clinical features of 97 cases. Ophthalmology. 2014;121(10):2040–2046.Google Scholar
  20. 20.
    Won SJ, Kook JA, Mi Rp et al. The radiological spectrum of orbital pathologies that involved the lacrimal gland and the lacrimal fossa. Korean J Radiol. 2007;8(4):336–342.Google Scholar
  21. 21.
    Jakobiec FA. Ocular adnexal lymphoid tumors: progress in need of clarification. Am J Ophthalmol. 2008;145(6):941–50.CrossRefGoogle Scholar
  22. 22.
    Jakobiec FA, Rashid A, Lane KA, et al. Granulomatous dacryoadenitis in regional enteritis (Crohn Disease). Am J Ophthalmol. 2014;158:838–44.CrossRefGoogle Scholar
  23. 23.
    Notz G, Intili A, Bilyk JR. IgG4-related dacryoadenitis in a 13 year old girl. Ophthal Plast Reconstr Surg. 2014;30(6):e161–3.CrossRefGoogle Scholar
  24. 24.
    Mombaerts I, Douglas Cameron J, Chanlalit W, et al. Surgical debulking for idiopathic dacryoadenitis. Ophthalmol. 2014;121:603–9.CrossRefGoogle Scholar
  25. 25.
    Mombaerts I, Schlingemann RO, Goldschmeding R, et al. Are systemic steroids useful in management of orbital pseudotumors? Ophthalmol. 1996;103:521–8.CrossRefGoogle Scholar
  26. 26.
    Leibovitch I, Prabhakaran VC, Davis G, et al. Intraorbital injection of Triamcinolone acetonide in patients with idiopathic orbital inflammation. Arch Ophthalmol. 2007;125:1647–51.CrossRefGoogle Scholar
  27. 27.
    Smith JR, Rosenbaum JT. A role for methotrexate in the management of non-infectious orbital inflammatory disease. Br J Ophthalmol. 2001;85:1220–4.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Garrity JA, Matteson EL. Biologic response modifiers for ophthalmologists. Ophthal Plast Reconstr Surg. 2008;24(5):345–7.CrossRefGoogle Scholar
  29. 29.
    Miquel T, Abad S, Badelon I, et al. Successful treatment of idiopathic orbital inflammation with infliximab: an alternative to conventional steroid-sparing agents. Ophthal Plast Reconstr Surg. 2008;24(5):415–6.CrossRefGoogle Scholar
  30. 30.
    Shekunov J, Griepentrog GJ, Diehl NN, et al. Prevalence and clinical characteristics of congenital dacryocystocele. JAAPOS. 2010;14(41):417–20.Google Scholar
  31. 31.
    Helper KM, Woodson GE, Kearns DR. Respiratory distress in the neonate. Sequela of a congenital dacrycystocele. Arch Otolaryngol Head Neck Surg. 1995;12:1423–5.Google Scholar
  32. 32.
    Bernadini FP, Cetinkaya A, Capris P, et al. Orbital and periorbital extension of congenital dacryocystoceles: suggested mechanism and management. Ophthal Plast Reconstr Surg. 2014;31(3):249–50.CrossRefGoogle Scholar
  33. 33.
    Chung SY, Rufailov L, Turbin RE, Langer PD. The microbiologic profile of dacryocystitis. Orbit. 2018; 11:1–7.  https://doi.org/10.1080/01676830.2018.1466901. (Epub ahead of print).
  34. 34.
    Becker BB. The treatment of congenital dacryocystocele. Am J Ophthalmol. 2006;142:835–8.CrossRefGoogle Scholar
  35. 35.
    Dhillon N, Kreis AJ, Maadge SN. Dacryolith induced acute dacryocystitis: a reversible cause of nasolacrimal duct obstruction. Orbit. 2014;33(3):199–201.CrossRefGoogle Scholar
  36. 36.
    Hawes MJ. The dacryolithiasis syndrome. Ophthal Plast Reconstr Surg. 1988;4(2):87–90.CrossRefGoogle Scholar
  37. 37.
    Mishra K, Hu KY, Kaamal s, Andron et al. Dacryolithiasis: a review. Ophthal Plast Reconstr Surg. 2017;33:83–89.Google Scholar
  38. 38.
    Salam A, Williams CPR, Manners RM. Expulsion of a lacrimal dacryolith by sneezing: a rare event. Eur J Ophthlmol. 2006;16(1):161–3.CrossRefGoogle Scholar
  39. 39.
    Kay-Wilson LG. Spontaneous passage of a dacryolith. Br J Ophtalmol. 1991;75:564.CrossRefGoogle Scholar
  40. 40.
    McGrath LA, Satchi K, McNab A. Recognition and management of acute dacryocystic retention. Ophthal Plast Reconstr Surg. 2018;34:333–5.PubMedGoogle Scholar
  41. 41.
    Smith B, Tenzel RR, Buffam FV, et al. Acute dacryocystic retention. Arch Ophthal. 1976;94:1903–4.CrossRefGoogle Scholar
  42. 42.
    Gonnering RS, Bosniak SL. Recognition and management of acute noninfectious dacryocystic retention. Ophthal Plast Reconstr Surg. 1989;5:27–33.CrossRefGoogle Scholar
  43. 43.
    Linberg J. Primary acquired nasolacrimal duct obstruction. A clinicopathologic report biopsy technique. Ophthalmology. 1986;93:1055.CrossRefGoogle Scholar
  44. 44.
    Eshraghi B, Abdi P, Akbari M, et al. Microbiologic spectrum of acute and chronic dacryocystitis. Int J Ophthalmol. 2014;7(5):864–7.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Maheshwari R, Maheshwari S, Shah T. Acute dacryocystitis causing orbital cellulitis and abscess. Orbit. 2009;28:196–9.CrossRefGoogle Scholar
  46. 46.
    Wladis EJ, Shinder R, LeFebvre DR, Sokol JA, et al. Clinical and microbiologic features of dacryocystitis-related orbital cellulitis. Orbit. 2016;35(5):258–61.CrossRefGoogle Scholar
  47. 47.
    Kikkawa DO, Heinz GW, Martin RT, et al. Orbital cellulitis and abscess secondary to dacryocystitis. Ophthamol Surg Lasers. 1997;31:201–2.Google Scholar
  48. 48.
    Lowry EA, Kalin-Hajdu E, Kersten RC, Vagefi MR. Acute vision loss from dacryocystitis. JAMA Ophthalmol. 2018;136(10):1207–8.CrossRefGoogle Scholar
  49. 49.
    Kalin Hajdu E, Cadet N, Boulos PR. Controversies of the lacrimal system. Surv Ophthalmol. 2016;61(3):309–13.CrossRefGoogle Scholar
  50. 50.
    Scully RE. Case records of the Massachusetts General Hospital. N Engl J Med. 1983;309:1171–4.CrossRefGoogle Scholar
  51. 51.
    Freedman JR, Markert MS, Cohen AJ. Promary and secondary lacrimal canliculitis: a review of the literature. Surv Ophthalmol. 2011;56:336–47.CrossRefGoogle Scholar
  52. 52.
    Kaliki S, Javed Ali M, Honnavar SG, et al. Primary canaliculitis:clinical features, microbiologic profile and management outcomes. Ophthal Plast Reconstr Surg. 2012;28(5):355–60.CrossRefGoogle Scholar
  53. 53.
    Dolman P. Infections of the orbit and ocular adnexa. In: Fay A, Dolman PJ, editors. Diseases and disorders of the orbit and ocular adnexa, chapter 10. Elsevier; 2017. pp 173–74.Google Scholar
  54. 54.
    SmartPlug Study Group. Management of complications after insertion of the SmartPlug punctal plug: a study of 28 patients. Ophthalmology. 2006;113:1859–62.CrossRefGoogle Scholar
  55. 55.
    Gogandy M, Al Sheik O, Chaudry I. Clinical features and bacteriology of lacrimal canaliculitis in patients presenting to a tertiary eye care center in Middle East. Saudi J Ophthalmol. 2014;28:31–5.CrossRefGoogle Scholar
  56. 56.
    Park A, Morgenstern KE, Kahwash SB, et al. Pediatric canaliculitis and stone formation. Ophthal Plast Reconstr Surg. 2004;20(3):243–6.CrossRefGoogle Scholar
  57. 57.
    Jordan DR, Agapitos PJ, McCunn D. Eikinella corrodens canaliculitis. Am J Ophthalmol. 1993;115(6):823–4.CrossRefGoogle Scholar
  58. 58.
    Moscata EE, Sires BB. Atypical canaliculitis. Ophthal Plast Reconstr Surg. 2008;24(1):54–5.CrossRefGoogle Scholar
  59. 59.
    Anand S, Hollingworth K, Kumar V, et al. Canaliculitis: the incidence of long-term epiphora following canaliculotomy. Orbit. 2004;23(1):19–26.CrossRefGoogle Scholar
  60. 60.
    Jones DB, Robinson NM. Anaerobic ocular infections. Trans Am Acad Ophthalmol Otolaryngol. 1977;83:309–12.Google Scholar
  61. 61.
    Mohan ER, Kabra S, Uday P, et al. Intracanalicular antibiotics may obviate the need for surgical management of chronic suppurative canaliculitis. Indian J Ophthalmol. 2008;56:338–40.CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Jin X, Zhao Y, Tong N, et al. Use of Crawford tube for chronic suppurative lacrimal canaliculitis. Ophthal Plast Reconstr Surg. 2014;30:229–32.CrossRefGoogle Scholar
  63. 63.
    Perumal B, Meyer DR. Vertical canaliculotomy with retrograde expression of concretions for the treatment of canaliculitis. Ophthal Plast Reconstr Surg. 2014;31(2):119–21.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Professor of OphthalmologyUniversity of Ottawa Eye InstituteOttawaCanada
  2. 2.OttawaCanada
  3. 3.Centro Oftalmologico y Oculoplastico de Madrid, Hospital Universitario Madrid Norte Sanchinarro, Hospital Universitario de FuenlabradaMadridSpain

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