Lacrimal Infections
Dacryoadenitis
- Symptoms include pain, tenderness and swelling of {the} lateral aspect of {the} eyelid
- May occur with systemic diseases such as Sjogren's, sarcoidosis, syphilis, TB, lymphoma, and benign lymphoid hyperplasia
- May occur in patients with mums, EBV, zoster
Canaliculitis
- Symptoms include pain, swelling, tenderness of {the} INNER canthus of {the} eye
- Etiology is usually actinomycetes
- May be treated with Penicillin irrigation
- Actinomycetes is also sensitive to gtts
Dacryocystitis
- Symptoms: acute onset, tearing (from nasolacrimal duct obstruction), redness, purulent discharge, tender swollen lacrimal sac
- An infection within {the} "tear duct" causes a painful swelling in {the} inner corner of {the} eyelids.
- If {the} tearing causes severe symptoms, surgery can be performed to create a new tear duct. This operation is called "dacryocystorhinostomy." (see below). Small silicone tubes my be placed in {the} tear system to keep {the} new tear duct open while healing occurs. Surgical elimination of {the} obstruction by creating a new tear duct is necessary to eliminate {the} tearing and infection that can result from such a blockage
Acute Dacryocystitis
- various etiologies, all cause nasolacrimal duct obstruction with obstruction of drainage from lacrimal sac to nose
- chronic tear stasis causes 2o infxn
- edema, erythema below medial canthal tendon w/lac sac distention
- +/- pain
- rule out ethmoidal sinusitis, don't probe
- Treatment
- warm compresses
- oral/IV abx (Keflex, Augmentin), topical only limited value
- Incision Drainage localized abscess
- Complications
- mucocele, chronic conjunctivitis, orbital cellulitis
- most need DCR after acute infection subsides
Chronic Dacryocystitis
- distended lac sac with minimal inflammation suppurative discharge from punctum c/w nasolacrimal duct obstruction
- probe/irrigate upper system only
- dacryoliths from Actinomyces, Candida, topical meds, can cause lacrimal colic if impacted in NLD
- Treatment
- usually needs DCR for resolution
Procedures
- Home
- Anophthalmos
- Blepharoplasty
- Blepharospasm
- Brow Lift
- Congenital
- Dry Eye
- Eyelid Laxity
- Face
- Infections
- Inflammation
- Lacrimal System
- Lagophthalmos
- Latisse
- Locate an MD
- Orbital Tumors
- Ptosis
- Skin Rejuvenation
- Skin Tumors
- Symblepharon
- Thyroid
- Trauma