Dacryoadenitis

• Symptoms include pain, tenderness and swelling of the lateral aspect of the eyelid
• May occur with systemic diseases such as Sjogren's, sarcoidosis, syphilis, TB, lymphoma, and benign lymphoid hyperplasia
• May occur in patients with mums, EBV, zoster

Canaliculitis

• Symptoms include pain, swelling, tenderness of the INNER canthus of the eye
• Etiology is usually actinomycetes

Dacryocystitis

• Symptoms: acute onset, tearing (from nasolacrimal duct obstruction), redness, purulent discharge, tender swollen lacrimal sac
• An infection within the "tear duct" causes a painful swelling in the inner corner of the eyelids.
• If the tearing causes severe symptoms, surgery can be performed to create a new tear duct. This operation is called "dacryocystorhinostomy." (see below). Small silicone tubes my be placed in the tear system to keep the new tear duct open while healing occurs. Surgical elimination of the obstruction by creating a new tear duct is necessary to eliminate the tearing and infection that can result from such a blockage

Acute Dacryocystitis

• many etiologies, all cause nasolacrimal duct obstruction with obstruction of drainage from lacrimal sac to nose
  • chronic tear stasis causes 2^o infxn
  • edema, erythema below medial canthal tendon w/lac sac distention
  • +/- pain
  • rule out ethmoidal sinusitis, don't probe
• Treatment
  • warm compresses
  • oral/IV abx (Keflex, Augmentin), topical only limited value
  • Incision Drainage localized abscess
• Complications
  • mucocele, chronic conjunctivitis, orbital cellulitis
  • most need DCR after acute infection subsides

Chronic Dacryocystitis

• distended lac sac with minimal inflammation suppurative discharge from punctum c/w nasolacrimal duct obstruction
• probe/irrigate upper system only
• dacryoliths from Actinomyces, Candida, topical meds, can cause lacrimal colic if impacted in NLD
• Treatment
  • usually needs DCR for resolution

Graves' disease is an autoimmune disease. It most commonly affects the thyroid, causing it to grow to twice its size or more (goiter), be overactive, with related hyperthyroid symptoms such as increased heartbeat, muscle weakness, disturbed sleep, and irritability. It can also affect the eyes, causing bulging eyes (exophthalmos). It affects other systems of the body, including the skin and reproductive organs. It affects up to 2% of the female population, often appears after childbirth, and has a female:male incidence of 5:1 to 10:1. It has a strong hereditary component; when one identical twin has Graves' disease, the other twin will have it 25% of the time. Smoking and exposure to second-hand smoke is associated with the eye manifestations but not the thyroid manifestations. Diagnosis is usually made on the basis of symptoms, although thyroid hormone tests may be useful, particularly to monitor treatment.

An abscess (Latin: abscessus) is a collection of pus (dead neutrophils) that has accumulated in a cavity formed by the tissue on the basis of an infectious process (usually caused by bacteria or parasites) or other foreign materials (e.g. splinters, bullet wounds, or injecting needles). It is a defensive reaction of the tissue to prevent the spread of infectious materials to other parts of the body

Edema is an abnormal accumulation of fluid beneath the skin, or in one or more cavities of the body. Generally, the amount of interstitial fluid is determined by the balance of fluid

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