Lacrimal disorders (PEARLS)
NCCPA™ PANCE Eyes, Ears, Nose, and Throat Content Blueprint eye disorders ⇒ lacrimal disorders
| Dacryoadenitis |
Patient will present as → a 12-year-old with severe unilateral right eye pain and pressure. On physical exam, there is swelling, redness, tearing, and drainage from the outermost part of the affected right eye. Dacryoadenitis
- Inflammation of the nasolacrimal duct or the nasolacrimal gland (supratemporal)
DX: The diagnosis is based on clinical observation ⇒ CT orbits if chronic
TX:
- If the cause of dacryoadenitis is a viral condition such as mumps, simple rest and warm compresses may be all that is needed
- For other causes, the treatment is specific to the causative disease
Dacryocystitis
DX:
- In acute cases of dacryocystitis, a Crigler, or tear duct massage can be performed to express material for culture and gram stain
- In patients who appear to be acutely toxic or those who present with visual changes, imaging and bloodwork should be considered
TX:
- Acute dacryocystitis (< 3 months) is treated with systemic antibiotics
- Chronic dacryocystitis (> 3 months) typically presents with fewer inflammatory signs and requires surgical therapy for the underlying cause
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