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

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

various etiologies, all cause nasolacrimal duct obstruction with obstruction of drainage from lacrimal sac to nose
- chronic tear stasis causes 2^o 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

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