DACRYOADENITIS

Course overview

DACRYOADENITIS REFERS TO ACUTE OR CHRONIC INFLAMMATION OF THE LACRIMAL GLAND AND CAN BE DUE TO INFECTIOUS, INFLAMMATORY, OR IDIOPATHIC CAUSES. ACUTE DACRYOADENITIS IS MOST COMMON IN CHILDREN AND YOUNG ADULTS AND TYPICALLY PRESENTS WITH ERYTHEMA AND TENDERNESS OVER THE SUPEROTEMPORAL ORBIT WITH ENLARGEMENT OF THE GLAND CAUSING THE LATERAL PORTION OF THE EYELID TO FALL, CREATING A CHARACTERISTIC S-SHAPED CURVE OF THE EYELID MARGIN. THERE CAN ALSO BE ASSOCIATED SUPPURATIVE DISCHARGE FROM LACRIMAL DUCTS, POUTING OF THE LACRIMAL DUCTULES, CONJUNCTIVAL CHEMOSIS, AND SWELLING OF PREAURICULAR AND CERVICAL LYMPH NODES. FEVER AND MALAISE MAY BE PRESENT. INFLAMMATORY CAUSES OF DACRYOADENITIS MAY PRESENT SUBACUTELY WITH TYPICALLY PAINLESS SWELLING OF THE LACRIMAL GLANDS AND MAY BE BILATERAL. ACUTE LACRIMAL GLAND SWELLING THAT PRESENTS IN ASSOCIATION WITH A VIRAL ILLNESS DOES NOT REQUIRE BIOPSY OR COMPREHENSIVE LABORATORY EVALUATION. HOWEVER, IF THERE ARE ATYPICAL FEATURES OR IF THE SWELLING DOES NOT RESOLVE WITH TREATMENT, AN ADDITIONAL WORKUP IS MERITED. OCCURRENCE IN OLDER ADULTS, BILATERAL PRESENTATION, AND SYSTEMIC SYMPTOMS MAY SUGGEST A MALIGNANT OR SYSTEMIC AUTOIMMUNE PROCESS, IN WHICH CASE ADDITIONAL WORKUP IS STRONGLY ADVISABLE. THIS ACTIVITY REVIEWS THE PRESENTATION, EVALUATION, AND MANAGEMENT OF DACRYOADENITIS AND STRESSES THE ROLE OF AN INTERPROFESSIONAL TEAM APPROACH TO CARE FOR AFFECTED PATIENTS.