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