PANCE Blueprint EENT (7%)


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.

image-dacryoadenitis-and-dacryocystitis Dacryoadenitis is inflammation of lacrimal (tear-producing) glands usually caused by bacteria or a virus that initiates the inflammation

  • s/sx: unilateral severe pain, swelling, redness, tearing, drainage
  • Common causes include mumps, Epstein-Barr virus, staphylococcus, and gonococcus

Dacryocystitis is infectious obstruction of the nasolacrimal duct (inferomedial region)

  • On the exam you may be able to differentiate based on the location: Dacryocystitis will be medial
  • Often caused by a stone, debris, or dacryostenosis (would be seen in small children) = congenital malformation or failure of duct to open
  • Dacryoadenitis may lead to dacryocystitis and periorbital cellulitis if untreated – redness to the nasal side of the lower lid

The diagnosis is based on clinical observation

  • CT orbits if chronic


  • 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 with systemic antibiotics: Clindamycin + 3rd gen. cephalosporin


Question 1

A 7 month old female is brought to your clinic by his mother who reports the child has had swelling of the nasal corner of the left eye.  If left untreated what condition can develop?

A hyphema is a collection of blood inside the front part of the eye (called the anterior chamber, between the cornea and the iris). The blood may cover part or all of the iris (the colored part of the eye) and the pupil, and may partly or totally block vision in that eye.
Papilledema (or papilloedema) is optic disc swelling that is caused by increased intracranial pressure. The swelling is usually bilateral and can occur over a period of hours to weeks.
a pterygium is an elevated, superficial, fleshy, triangular-shaped “growing” fibrovascular mass (most common in inner corner/nasal side of they eye
Question 1 Explanation: 
Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac. It may be a complication of untreated dacryoadenitis. Dacryocystitis may lead to failure to thrive.
There is 1 question to complete.
Shaded items are complete.
Lacrimal disorders (PEARLS) (Prev Lesson)
(Next Lesson) Lid disorders (PEARLS)
Back to PANCE Blueprint EENT (7%)


The Daily PANCE and PANRE

Get 60 days of PANCE and PANRE Multiple Choice Board Review Questions delivered daily to your inbox. It's 100% FREE and 100% Awesome!

You have Successfully Subscribed!