Watery Eyes
Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen in 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.
Punctal dilatation and non-incisional canalicular curettage in the management of infectious canaliculitis
Published in Orbit, 2020
Nandini Bothra, Abhimanyu Sharma, Oshin Bansal, Mohammad Javed Ali
Institutional review board approval was obtained and the study adhered to the tenets of the Declaration of Helsinki. A retrospective analysis of 53 canaliculi of 47 eyes of 46 consecutive patients diagnosed with canaliculitis was performed from November 2015 to December 2018. All the patients were evaluated by an oculoplastic surgeon with the help of a slit-lamp examination. None of the patients had any history of trauma or associated conjunctivitis or history of past surgical interventions on the canaliculus. The diagnosis of canaliculitis was based on a combination of classical clinical features of epiphora, discharge from the punctum, tender swelling and erythema over the canaliculus and microbiological examination. All patients were treated with punctal dilatation and a non-incisional canalicular curettage. Parameters studied include demographics, clinical presentation, microbiological analysis, management and treatment outcomes.
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.
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