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Orbital Inflammatory Syndromes
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Jaspreet Sukhija, Savleen Kaur
Localized OIS may occur in the lacrimal gland, EOMs, or optic nerve sheath. The typical acute presentation of dacryoadenitis includes pain, enlargement of the lacrimal gland, an S-shaped ptosis of the upper eyelid, and tenderness to palpation. Inflammatory disease of the lacrimal gland may also present in a subacute or chronic form in which a painless mass appears in the region of the lacrimal fossa.
Ophthalmology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
See also Chapter 8 Neurology, page 203. Dacryoadenitis, usually caused by a viral infection of the lacrimal gland but may be associated with orbital pseudotumour. It is not usually associated with proptosis per se but causes the upper lid to develop an ‘S’ shape and is very tender to touch. Treatment is with pain relief and antibiotics if from an infectious cause, but if pseudotumuour related, steroids are indicated. CT scan is usually needed to make the distinction together with serology.Dacryops is due to a dilatation of the major lacrimal ducts secondary to obstruction and again does not usually cause proptosis.Pleomorphic adenoma. Very rarely this essentially ‘adult’ tumour presents in children with a painless, slowly progressive non-axial proptosis. Biopsy may be needed to make the diagnosis. It is very rare.
Ophthalmology
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Dacryoadenitis (inflammation of the lacrimal gland):1 Viral infection, e.g. mumps.2 Sarcoidosis.
Bacterial dacryoadenitis: clinical features, microbiology, and management of 45 cases, with a recent uptick in incidence
Published in Orbit, 2022
Karen M. Wai, Joseph J. Locascio, Natalie Wolkow
Dacryoadenitis refers to inflammation of the lacrimal gland, and is relatively rare with an overall reported incidence of 1:10,000 ophthalmic cases.1 There is a wide range of etiologies that can cause dacryoadenitis, including infectious, autoimmune, infiltrative, or idiopathic. Dacryoadenitis is most often associated with autoimmune or inflammatory causes such as immunoglobulin G4 (IgG4)-related disease, sarcoidosis, or granulomatosis with polyangiitis.2 In cases of acute or subacute onset lacrimal gland inflammation, infectious sources of dacryoadenitis are typically considered higher on the differential.3 Classically, the causative organisms of infectious dacryoadenitis are most commonly considered to be viruses such as Epstein Barr virus (EBV), while bacterial organisms are thought to be rare. Despite its supposed rarity, in recent years at our institution it was felt that the incidence of bacterial dacryoadenitis may be increasing. We sought to better understand this possible trend by systematically reviewing all cases of dacryoadenitis presenting to Mass Eye and Ear over a 16-year period.
SLE dacryoadenitis
Published in Orbit, 2019
Yu-Chieh Hung, Delia D. Wang, Louis S. M. Han, Thomas D. Betts, Robert G. Weatherhead
It is unusual to present with severe eyelid swelling secondary to dacryoadenitis, then after resolution, have the same appearance develop on the contralateral side, such as in our patient. To our knowledge, there are only two other cases in the literature of eyelid swelling as the presenting symptom in SLE.8,9 Burkhalter8 reported a case of a 17-year-old Filipino female who had presented with a 3-week history of right lateral upper lid swelling. Histology from her right lacrimal gland showed sclerosing inflammatory pseudotumour.8 She later developed a rash and muscle weakness, and was diagnosed with SLE after a positive ANA.8 Al-Busaidi et al.9 described an 18-year-old Asian female with acute dacryoadenitis as the initial feature of SLE. She had presented with 2 weeks of right lateral upper lid swelling, and was found to have the following positive immunological findings: ANA, anti-dsDNA, anti-ribosomal P, RNP, and anti-Sm.9
Suspected orbital myositis associated with COVID-19
Published in Orbit, 2021
Blair K. Armstrong, Ann P. Murchison, Jurij R. Bilyk
Noninfectious orbital inflammation associated with COVID-19 is rare.5 Martínez Díaz et al. recently reported one case of inflammatory dacryoadenitis in a 22-year-old patient.9 The patient had an elevated c-reactive protein; otherwise, serologic work-up was unremarkable. Similar to our case, the patient did not respond to systemic antibiotic therapy but improved markedly with systemic corticosteroids. Dinkin and colleagues described one case of perineuritis and surrounding intraconal orbital fat inflammation with normal autoimmune serologies.10 The patient also responded to systemic corticosteroids. In this manuscript, we describe the first patient with presumed orbital myositis following SARS-CoV19 infection.