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Watery Eyes
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Canaliculitis: Presents with acute or chronic inflammation around the canaliculi and adjacent lid margin with pus visible on manipulation of the area. Treatment involves warm compresses and topical chloramphenicol in the eye casualty setting, but the patient should be referred to oculoplastics for surgical canaliculotomy to remove concretions, sulphur granules and discharge. The organism responsible for canaliculitis is classically actinomyces iraelii.
Lacrimal Drainage Infections with Sphingomonas paucimobilis: Clinical Presentations, Complications and Outcomes
Published in Current Eye Research, 2023
Prerna Sinha, Sanchita Mitra, Nandini Bothra, Mohammad Javed Ali
Sphingomonas paucimobilis has been reported on several occasions to cause keratitis and endophthalmitis, either exogenous or endogenous.17,19,20,28–38 Adnexal involvement has only lacrimal canaliculitis cases in literature. Gogandy et al. described four cases of Sphinogomonas paucimobilis canaliculitis from the Middle East, but their presentation and management details were not described in detail.19 Another isolated case report is that by Vempuluru VS et al. in 2021, where the resolution of symptoms was noted after a punctal dilation and non-incisional curettage like in the present series.20 It is not surprising that most canaliculitis patients in the present series responded to a minimally invasive intervention of non-incisional curettage. This can be attributed to the low virulence and good sensitivity profile of the Sphingomonas. Only a single patient required incisional punctoplasty. Although nonincisional interventions are ideal for punctum and canalicular disorders and should be pursued primarily for several reasons,39 the recalcitrant and recurrent ones may resolve only with incisional techniques.40
Chronic canaliculitis with canaliculoliths due to Providencia stuartii infection
Published in Orbit, 2023
Jenny Lin, Victoria S. North, Christopher Starr, Kyle J. Godfrey
Canaliculitis is inflammation of the lacrimal canaliculus, with primary canaliculitis the result of infection of the canaliculus and secondary canaliculitis most related to punctal and intracanalicular plug placement.1 The classic presenting symptoms of canaliculitis include epiphora, medial canthal swelling, nonresolving or recurrent conjunctivitis, a swollen, pouting punctum, and punctal discharge or concretions.1 It is often misdiagnosed as conjunctivitis, leading to delayed therapeutic and surgical management.1 Although Actinomyces israelii is the most common causative microorganism, an increasing number of studies describe additional responsible bacteria including Streptococcus and Staphylococcus species.2–4 The authors present a case of chronic canaliculitis with canaliculoliths due to Providencia stuartii, which has not been reported as a canaliculitis or canaliculolith causing pathogen. Collection and evaluation of protected patient health information were compliant with the Health Insurance Portability and Accountability Act and the Declaration of Helsinki.
Outcomes of Canaliculotomy with and without Silicone Tube Intubation in Management of Primary Canaliculitis
Published in Current Eye Research, 2021
Mingling Wang, Richang Cong, Bo Yu
Multiple procedures have been described to completely remove the canalicular contents and improve the effectiveness of treatment. These include dilatation of the punctum with curettage, punctoplasty techniques or canaliculotomy with curettage.8–10 The most widely accepted treatment for primary canaliculitis is standard canaliculotomy and curettage of the canaliculus.5,8,11 Canaliculotomy with curettage has a higher success rate because of the excellent exposure to remove all contents during surgery. The majority of patients with canaliculitis treated with canaliculotomy have reported complete resolution.5,12 However, after this procedure, the main complaint from patients is continued epiphora that may be related to dysfunction of the lacrimal pump and obstruction of the canalicular caused by postoperative scaring.1,2,5