Inflammation of the lacrimal gland and lacrimal sac

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Inflammation of the lacrimal gland (dacryoadenitis)[edit | edit source]

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

Acute lacrimal gland inflammation[edit | edit source]

  • 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[edit | edit source]

  • 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[edit | edit source]

  • 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[edit | edit source]

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

Lacrimal sac inflammation[edit | edit source]

Acute dacryocystitis[edit | edit source]

  • 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[edit | edit source]

  • 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[edit | edit source]

  • 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[edit | edit source]

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

Therapy[edit | edit source]

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

Links[edit | edit source]

Source[edit | edit source]

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

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