Skip to main content

Dacryoadenitis, Dacryocystitis, and Canaliculitis

  • Chapter
  • First Online:
  • 1057 Accesses

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

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Suggested Readings

  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. Goold LA, Madge SN, Au A, et al. Acute suppurative bacterial dacryoadenitis: a case series. Br J Ophthalmol. 2013;97(6):735–8.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  5. Tomita M, Shimmura S, Tsubota K, et al. Dacryoadenitis associated with acanthamoeba keratitis. Arch Ophthalmol. 2006;124:1239–42.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  7. Nieto JC, Kim N, Lucarelli MJ. Dacryoadenitis and orbital myositis associated with Lyme disease. Arch Ophthalmol. 2008;126(8):1165–6.

    Article  PubMed  Google Scholar 

  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. Lu W, Rootman DB, Berry JL, et al. Methicillin resistant Staphyloccous aureus dacryoadenitis. JAMA Ophthalmol. 2014;132(8):993–5.

    Article  Google Scholar 

  10. Ostri C, Heegaurd S, Prause JU. Sclerosing Wegener’s Granulomatosis in the orbit. Acta Ophthalmol. 2008;86(8):917–20.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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. 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.

    Article  CAS  PubMed  Google Scholar 

  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.

    PubMed  Google Scholar 

  15. McNab AA. Orbital inflammation in Churg-Strauss syndrome. Orbit. 1998;17(3):203–5.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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. Jakobiec FA. Ocular adnexal lymphoid tumors: progress in need of clarification. Am J Ophthalmol. 2008;145(6):941–50.

    Article  PubMed  Google Scholar 

  22. Jakobiec FA, Rashid A, Lane KA, et al. Granulomatous dacryoadenitis in regional enteritis (Crohn Disease). Am J Ophthalmol. 2014;158:838–44.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  24. Mombaerts I, Douglas Cameron J, Chanlalit W, et al. Surgical debulking for idiopathic dacryoadenitis. Ophthalmol. 2014;121:603–9.

    Article  Google Scholar 

  25. Mombaerts I, Schlingemann RO, Goldschmeding R, et al. Are systemic steroids useful in management of orbital pseudotumors? Ophthalmol. 1996;103:521–8.

    Article  CAS  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Garrity JA, Matteson EL. Biologic response modifiers for ophthalmologists. Ophthal Plast Reconstr Surg. 2008;24(5):345–7.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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. 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.

    Article  Google Scholar 

  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. Becker BB. The treatment of congenital dacryocystocele. Am J Ophthalmol. 2006;142:835–8.

    Article  PubMed  Google Scholar 

  35. Dhillon N, Kreis AJ, Maadge SN. Dacryolith induced acute dacryocystitis: a reversible cause of nasolacrimal duct obstruction. Orbit. 2014;33(3):199–201.

    Article  PubMed  Google Scholar 

  36. Hawes MJ. The dacryolithiasis syndrome. Ophthal Plast Reconstr Surg. 1988;4(2):87–90.

    Article  CAS  PubMed  Google Scholar 

  37. Mishra K, Hu KY, Kaamal s, Andron et al. Dacryolithiasis: a review. Ophthal Plast Reconstr Surg. 2017;33:83–89.

    Google Scholar 

  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.

    Article  CAS  Google Scholar 

  39. Kay-Wilson LG. Spontaneous passage of a dacryolith. Br J Ophtalmol. 1991;75:564.

    Article  Google Scholar 

  40. McGrath LA, Satchi K, McNab A. Recognition and management of acute dacryocystic retention. Ophthal Plast Reconstr Surg. 2018;34:333–5.

    PubMed  Google Scholar 

  41. Smith B, Tenzel RR, Buffam FV, et al. Acute dacryocystic retention. Arch Ophthal. 1976;94:1903–4.

    Article  CAS  PubMed  Google Scholar 

  42. Gonnering RS, Bosniak SL. Recognition and management of acute noninfectious dacryocystic retention. Ophthal Plast Reconstr Surg. 1989;5:27–33.

    Article  CAS  PubMed  Google Scholar 

  43. Linberg J. Primary acquired nasolacrimal duct obstruction. A clinicopathologic report biopsy technique. Ophthalmology. 1986;93:1055.

    Article  CAS  PubMed  Google Scholar 

  44. Eshraghi B, Abdi P, Akbari M, et al. Microbiologic spectrum of acute and chronic dacryocystitis. Int J Ophthalmol. 2014;7(5):864–7.

    PubMed  PubMed Central  Google Scholar 

  45. Maheshwari R, Maheshwari S, Shah T. Acute dacryocystitis causing orbital cellulitis and abscess. Orbit. 2009;28:196–9.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. Lowry EA, Kalin-Hajdu E, Kersten RC, Vagefi MR. Acute vision loss from dacryocystitis. JAMA Ophthalmol. 2018;136(10):1207–8.

    Article  PubMed  Google Scholar 

  49. Kalin Hajdu E, Cadet N, Boulos PR. Controversies of the lacrimal system. Surv Ophthalmol. 2016;61(3):309–13.

    Article  PubMed  Google Scholar 

  50. Scully RE. Case records of the Massachusetts General Hospital. N Engl J Med. 1983;309:1171–4.

    Article  Google Scholar 

  51. Freedman JR, Markert MS, Cohen AJ. Promary and secondary lacrimal canliculitis: a review of the literature. Surv Ophthalmol. 2011;56:336–47.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. SmartPlug Study Group. Management of complications after insertion of the SmartPlug punctal plug: a study of 28 patients. Ophthalmology. 2006;113:1859–62.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  56. Park A, Morgenstern KE, Kahwash SB, et al. Pediatric canaliculitis and stone formation. Ophthal Plast Reconstr Surg. 2004;20(3):243–6.

    Article  PubMed  Google Scholar 

  57. Jordan DR, Agapitos PJ, McCunn D. Eikinella corrodens canaliculitis. Am J Ophthalmol. 1993;115(6):823–4.

    Article  CAS  PubMed  Google Scholar 

  58. Moscata EE, Sires BB. Atypical canaliculitis. Ophthal Plast Reconstr Surg. 2008;24(1):54–5.

    Article  Google Scholar 

  59. Anand S, Hollingworth K, Kumar V, et al. Canaliculitis: the incidence of long-term epiphora following canaliculotomy. Orbit. 2004;23(1):19–26.

    Article  PubMed  Google Scholar 

  60. Jones DB, Robinson NM. Anaerobic ocular infections. Trans Am Acad Ophthalmol Otolaryngol. 1977;83:309–12.

    CAS  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David R. Jordan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Jordan, D.R., Stoica, B. (2020). Dacryoadenitis, Dacryocystitis, and Canaliculitis. In: El Toukhy, E. (eds) Oculoplastic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-36934-7_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-36934-7_25

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-36933-0

  • Online ISBN: 978-3-030-36934-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics