Dacryoadenitis

Dacryoadenitis 

  • Inflammation of the lacrimal gland.
  • May be caused by viral or bacterial infections or other inflammatory conditions such as sarcoidosis or thyroid orbitopahy.

Clinical features:  

  • Symptoms: orbital discomfort, lid swelling, redness and discharge.
  • Signs:
    • Upper lid swelling, redness, warmth and tenderness to palpation
    • Swollen palpebral lobe of the lacrimal gland can be easily visualized in the supratemporal fornix by everting the upper lid while having the patient looking down.
    • May be present with globe displacement or proptosis if orbital lobe involved

Work up:

  • Culture and Gram staining of discharge, CBC, consider blood culture if systemic involvement is suspected.
  • Orbital CT-scan if there is:
    • Progressive proptosis
    • Ocular movement restriction
    • Malignancy suspected.

Management:

  • Complete ophthalmic history and examination.
  • Treat the underlying infection or inflammation.