Inflammation of the lacrimal gland and lacrimal sac

Inflammation of the lacrimal gland (dacryoadenitis)

• mostly one-sided
• occurring mainly in children and young people
• acute or chronic

Acute lacrimal gland inflammation

• often a complication of other diseases (mononucleosis, influenza, typhus, scarlatina)
• less often, the cause of inflammation is the onset of infection in conjunctivitis
• agents are:

1. viruses (EBV, HZV, Influenzaviruses)
2. bacteria (Streptococci)

Clinical symptoms

• swelling of the outer third (up to a half) of the upper eyelid
• very painful
• the edge of the lid is sigmoidally curved
• tearing and conjunctival chemosis, sometimes enlarged preauricular nodes
• differential diagnosis: chalazion, hordeolum, tumor
• if a tumor is suspected, we do not, in any case, perform a biopsy, which could harm the patient by the occurrence of metastases or recurrence

Therapy

• for viral dacryoadenitis, we administer analgesics and cold compresses
• in the case of bacterial origin, we treat the patient with antibiotics or incisions

Chronic lacrimal gland inflammation

• bilateral
• often a part of systemic diseases (sarcoidosis)
• bulbus is oppressed nasally down → exophthalmos

Lacrimal sac inflammation

Acute dacryocystitis

• in young children or people over 40 years of age
• the reason is mainly an obstacle in the outflow of tears due to narrowing or closure of the tear duct due to:

1. congenital obstruction ductus nasolacrimalis
2. stone or outcrop in lacrimal duct
3. after surgery in the oral cavity or jaw
4. after trauma

• infection of accumulating secretion occurs most often by bacteria Staphylococcus aureus, H. influenzae, Proteus vulgaris, rarely Candida albicans.

Clinical symptoms

• lacrimation (epiphora)
• the pain is likened to a renal colic, spreading to the middle of the head and teeth
• lacrimation and secretion in the inner corner
• the lacrimal sac is red and edematous, it may contain mucous secretions

Complications: transfer of infection to the orbit

Therapy

• in the first phase of the disease, we administer ATB, we do not try to probe (there would be a risk of spreading the infection)
• later incision and drainage
• if it persists, we solve the problem surgically using a dacryocystorhinostomy

Chronic dacryocystitis

• arises sneakily, alternating periods of calm and inflammatory activity
• manifested by tearing, the lacrimal sac may be swollen with mucus

Therapy

• antibiotics can only alleviate symptoms, but do not lead to permanent elimination of the problem
• dacryocystorhinostomy

Links

Source

• ROZSÍVAL, Pavel. Oční lékařství. 1. edition. 2006. pp. 373. ISBN 80-7262-404-0.