Primary and Secondary Lacrimal Canaliculitis: A Review of Literature

Lacrimal canaliculitis, both primary and secondary, presents unique challenges in diagnosis and
management. A thorough understanding of the existing literature is crucial for healthcare
professionals to effectively tackle this condition. However, delving into the vast array of research
papers, articles, and studies can be daunting and time-consuming. The complexity of the topic,
coupled with the need for comprehensive analysis, makes writing a literature review on primary and
secondary lacrimal canaliculitis a challenging task.

Primary lacrimal canaliculitis refers to inflammation or infection of the lacrimal canaliculus without
any predisposing factors, whereas secondary canaliculitis occurs due to underlying conditions such
as trauma, foreign body presence, or chronic inflammation. Both variants demand a nuanced
approach in understanding their etiology, clinical presentation, diagnostic modalities, and treatment
strategies.

Navigating through the extensive body of literature on lacrimal canaliculitis requires expertise and
patience. It involves reviewing numerous studies, clinical trials, case reports, and expert opinions to
extract relevant information and draw meaningful conclusions. Additionally, the synthesis of diverse
perspectives and findings into a coherent narrative adds another layer of complexity to the task.

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canaliculitis without the hassle of extensive research and analysis, ⇒ StudyHub.vip ⇔ offers a
convenient solution. Our team of experienced writers specializes in crafting well-researched and
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information on lacrimal canaliculitis.

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written literature reviews on primary and secondary lacrimal canaliculitis. Trust us to deliver
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Most identified plug was SmartPlug (seven cases), followed by EaglePlug (two cases) and Herrick
Lacrimal Plug (two cases). Canaliculitis can be differentiated from dacryocystitis. Some studies
demonstrate an average of four antibiotic irrigation treatments was needed to eradicate the infection.
They may even be responsible for the phenomena of false soft stops observed in preoperative
syringing cases in endoscopic exams, according to study results published in Ophthalmic Plastic and
Reconstructive Surgery. You can see this groove in the image, labeled as fossa for lacrimal sac. This
operation is called “dacryocystorhinostomy.” (see below). Small silicone tubes may be placed in the
tear system to keep the new tear duct open while healing occurs. Primary canaliculitis: The
incidence, clinical features, outcome and long-term epiphora after snip-punctoplasty and curettage.
The most common presenting symptom was discharge in both groups (85% and 79%, respectively).
Historically, the presence of concretions was considered to be firm evidence of canaliculitis, which
was later extended to include pericanalicular inflammation and pouting puncta. The most common
causative organisms are the Actinomyces species, but recent studies indicate high rates of infection
with streptococcal and staphyloccal bacteria. On examination, the lacrimal punctum is swollen and
inflamed. This already delicate structure can be affected by osteoporosis ); there is a correlation
between lacrimal bone thickness and general bone density throughout the body. Usually, aerobic and
anaerobic cultures are requested. Staining could be performed with different stain and microscopic
assessment could reveal the presence of organisms such as Actinomyces or aspergillus. It commonly
affects individuals over the age of 50 years. It is an uncommon condition which ophthalmologists
frequently misdiagnose. If you provide content to customers through CloudFront, you can find steps
to troubleshoot and help prevent this error by reviewing the CloudFront documentation. Visible
CLS-MFs were observed in 22 lacrimal systems (61.1%), 3 of which were overhanging the ICO and
required manipulation of the probe to enter the lacrimal sac. In the event of this being the case,
patients might possibly require to undergo a surgical procedure to help clear the infection. When the
bones crack but do not shift, surgery is avoided. Articulations rather than fixed sutures mean there is
a very small range of motion when these bones move and, therefore, play a protective role. Other
causes can include aspergillus, Canada albicans and even herpes simplex and herpes zoster virus.
Feroze; Bhupendra C. Patel. Author Information and Affiliations Authors Kaberi B. Which of these
lacrimal bone structures is an attachment point for the orbicularis oculi? A. Infection by these
organisms results in the formation of tiny stones that are rich in sulphur. Le Fort III fractures of the
mid-face typically present with lacrimal bone fractures, in combination with complex mid-face
fractures of the bones that surround the nose and eyes. These yellowish granules are called sulfur
granules, and they are thought to be caused by Actinomyces species. Ophthalmic Plast Reconstr
Surg. 2020;36(4):410-413. Clinical features and bacteriology of lacrimal canaliculitis in patients
presenting to a tertiary eye care center in the Middle East. However, the other causes can include
aspergillus, Canada albicans and even herpes simplex and herpes zoster virus.
Distension of lacrimal sac by trapped amniotic fluid (amniontocele). This book is distributed under
the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
(CC BY-NC-ND 4.0). Laboratory investigations are conducted on the discharge. Especially as the
lacrimal and ethmoid bones are described as being of similar strength to an egg-shell when compared
to other facial bones. You can see this groove in the image, labeled as fossa for lacrimal sac. When
the bones crack but do not shift, surgery is avoided. Patients may present with watering, discharge, a
pouting punctum, or a medial canthal swelling. Get help Privacy Policy Password recovery Recover
your password your email A password will be e-mailed to you. Some studies demonstrate an average
of four antibiotic irrigation treatments was needed to eradicate the infection. The right-hand side of
this picture of the left-hand side skull shows the bone fitting snugly into the eye socket. The frontal
process with lacrimonasal groove The lacrimal bones also border with the eye socket-facing surface
of the ethmoid bone. Often, the patient will not remember having had plugs inserted. Recurrent or
complicated cases may require dacryocystorhinostomy, removal of any intracanalicular foreign
bodies or debris, and stent placement. Try again later, or contact the app or website owner. It is an
attachment point for the orbicularis oculi muscle that closes the eyelids. Disclosure: Bhupendra Patel
declares no relevant financial relationships with ineligible companies. Which of these lacrimal bone
structures is an attachment point for the orbicularis oculi? A. Various studies demonstrate that the
most common signs in primary canaliculitis are punctal swelling, eyelid swelling, and discharge or
concretions from the punctum. The normal punctum is in contact with the globe and is not usually
visible without pulling the lower eyelid downwards and the upper eyelid upwards. The lower
canaliculus and the lacrimal sac should be palpated and compressed. Any lacerations to the tear ducts
must be carefully closed to avoid permanent blockage of the nasolacrimal duct. Recent studies,
however, demonstrate an increased incidence of Staphylococcus and Streptococcus. In cases of
blockages due to congenital deformities, the ducts can be accessed via the inside of the nasal passage
or via the corner of the eye. Procedures can include deployment of the canaliculus through a
procedure called canaliculotomy. Patients may be required to undergo a surgical procedure to help
clear the infection. It can demonstrate canalicular changes and canaliculith. Antibiotic selection is
usually needed to treat the infection, and the application of warm compresses has been shown to
help treat these infections by expediting recovery and minimizing the symptoms from the
inflammation. Treatment includes irrigation of the canaliculus with antibiotic solution, and removal
of any concretions, which usually requires surgery. The most common cause of canaliculitis is
Actinomyces Israelii. When the nasal bone is removed, the front (superior) surface of each tiny bone
can be seen in its entirety.
Differential Diagnosis Carcinoma of the lacrimal canaliculus Chronic conjunctivitis Dacryocystitis
Migrated punctal plug Pearls and Other Issues Canaliculitis is a condition which is commonly
misdiagnosed or diagnosed late. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Results Of
76 eligible cases collected, 13 were plug-related canaliculitis and 63 were primary canaliculitis. Each
bone borders the frontal process of the maxilla (see image) and the orbital plate of the frontal bone
that forms the recessed area of the eye socket at the top of the eye socket. It consists of: The lacrimal
gland, which secretes the tears, and its excretory ducts, which convey the fluid to the surface of the
human eye;it is a serous gland located in lacrimal fossa. This could be due to hormonal factors which
can affect tear production rendering the canaliculus prone to microbial invasion. When the nasal
bone is removed, the front (superior) surface of each tiny bone can be seen in its entirety. These
stones form little pockets that unfortunately are not affected by the antimicrobial properties of tears.
Recent studies, however, demonstrate an increased incidence of Staphylococcus and Streptococcus.
The intracanalicular plug was removed via an open dacryocystorhinostomy and (more.) Figure 60-
year-old female presents with a six-month history of swelling of the medial lower eyelid, discharge
and tenderness. The medial surface provides a bony surface for the middle meatus of the nose that
helps to support the front part of the middle concha (see image below). It has a long groove (furrow)
along its length that runs in the same direction as the posterior lacrimal crest. It is characterised by
bacterial or fungal infections within the canaliculi and the formation of concretions that are rich in
sulphur. Lateral surface refers to the side surfaces of this bone. This material may not be published,
broadcast, rewritten or redistributed in any form without prior authorization. Website and Marketing
by Digital Standout This site is protected by reCAPTCHA and the Google Privacy Policy and Terms
of Service apply. When gently compressed, the cloudy, purulent discharge is expressed through the
punctum. Mehrotra N, Baidya A, Brijwal M, Aggarwal R, Chaudhry R. Procedures can include
deployment of the canaliculus through a procedure called canaliculotomy. These stones form little
pockets that unfortunately are not affected by the antimicrobial properties of tears. Symptoms and
signs are tearing, discharge, red eye (especially nasally), and mild tenderness over the involved side.
We can't connect to the server for this app or website at this time. Treatments can include topical
antibiotics and drainage, though in some cases surgical treatment might possibly be required. These
bones are colored in shades of pink in the below image of the orbital bones. Expressed mucopurulent
materialPainless swelling at inner canthus. The most common cause of canaliculitis is Actinomyces
Israelii. Secondary plug-related canaliculitis also is seen more commonly in females, probably
because of a larger number of female patients who are treated with plug placement for dry eye
symptoms. Most studies have found a higher incidence of involvement of the lower canaliculus. The
outflow of tears is accomplished by the lacrimal drainage system and it includes the following
anatomical structures. Secondary canaliculitis is often seen as a complication of punctal or
intercanalicular plug insertion for treatment of dry eye. Secondary canaliculitis due to punctal plugs
is very common.
The lower canaliculus is almost entirely horizontal. There might be too much traffic or a
configuration error. Canaliculitis can be differentiated from dacryocystitis. An early diagnosis is vital
for a complete cure, and chronic cases have more complications and a poorer prognosis. Report Back
from San Antonio Breast Cancer Symposium (SABCS) 2023: Spotlight. An infection within the
“tear duct” causes a painful swelling in the inner corner of the eyelids. The procedure is fairly
straightforward and is performed by making a tiny incision on the conjunctival aspect of the
canaliculus. Some studies demonstrate an average of four antibiotic irrigation treatments was needed
to eradicate the infection. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Primary
canaliculitis: clinical features, microbiological profile, and management outcome. The swelling is due
to accumulation of fluid and is called oedema. As bacterial infection is the most common etiology,
most treatment is aimed at eradicating gram positive bacteria. The lacrimal bone is very small and
quite delicate. Procedures can include deployment of the canaliculus through a procedure called
canaliculotomy. Various studies demonstrate that the most common signs in primary canaliculitis are
punctal swelling, eyelid swelling, and discharge or concretions from the punctum. Procedures can
include deployment of the canaliculus through a procedure called canaliculotomy. This infection is
often brought on by bacteria though there might possibly be alternative aetiology such as fungi and
viruses as well. Where the orbicularis oculi detach from the posterior lacrimal crest, the tendon of this
muscle is fixed into place using screw holes and sutures. On examination, the lacrimal punctum is
swollen and inflamed. This infection is often brought on by bacteria though there could be
alternative etiology such as fungi and viruses as well. It has a long groove (furrow) along its length
that runs in the same direction as the posterior lacrimal crest. This operation is called
“dacryocystorhinostomy.” (see below). Small silicone tubes may be placed in the tear system to keep
the new tear duct open while healing occurs. Lateral surface refers to the side surfaces of this bone.
Feroze 1; Bhupendra C. Patel 2. Affiliations 1 King Faisal University 2 University of Utah Last
Update: July 31, 2023. However, in recurrent or atypical cases, fungal and mycobacterial cultures
may also be done. Secondary plug-related canaliculitis also is seen more commonly in females,
probably because of a larger number of female patients who are treated with plug placement for dry
eye symptoms. Most studies have found a higher incidence of involvement of the lower canaliculus.
These borders help us to pinpoint the lacrimal bone location. If the breaks have caused changes in
position, they will need to be surgically treated. Differential Diagnosis Carcinoma of the lacrimal
canaliculus Chronic conjunctivitis Dacryocystitis Migrated punctal plug Pearls and Other Issues
Canaliculitis is a condition which is commonly misdiagnosed or diagnosed late. The three nasal
conchae Lacrimal Bone Borders The lacrimal bone has four borders with other craniofacial bones
called articulations.
Many authors now emphasize early diagnosis and prompt institution of surgical management for the
management of canaliculitis. The two bones also have articulations with the frontal, ethmoid, and
maxilla bones, and the nasal concha. You can see this groove in the image, labeled as fossa for
lacrimal sac. An infection within the “tear duct” causes a painful swelling in the inner corner of the
eyelids. Try again later, or contact the app or website owner. Feroze; Bhupendra C. Patel. Author
Information and Affiliations Authors Kaberi B. Log into your account your username your
password Forgot your password. Results Of 76 eligible cases collected, 13 were plug-related
canaliculitis and 63 were primary canaliculitis. Microscopically these consist of glandular tissue (acini
and ducts), connective. They may even be responsible for the phenomena of false soft stops observed
in preoperative syringing cases in endoscopic exams, according to study results published in
Ophthalmic Plastic and Reconstructive Surgery. Direction of the NLD is downwards, backwards and
laterally. Charts were reviewed for clinical features, microbiological profiles, time lapse between plug
insertion and symptom onset, type of plug and outcomes. Treasure Island (FL): StatPearls
Publishing; 2024 Jan-. This activity describes the cause, pathophysiology, presentation and diagnosis
of canaliculitis and highlights the role of the interprofessional team in its management. The frontal
process with lacrimonasal groove The lacrimal bones also border with the eye socket-facing surface
of the ethmoid bone. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Ophthalmic Plast
Reconstr Surg. 2020;36(4):410-413. Often, the patient will not remember having had plugs inserted.
Tests are conducted to ascertain the type of infection that is affecting the canaliculus. Treatment
includes irrigation of the canaliculus with antibiotic solution, and removal of any concretions, which
usually requires surgery. Canaliculotomy with the removal of the plug is considered the treatment of
choice for plug-related canaliculitis. Differential Diagnosis Carcinoma of the lacrimal canaliculus
Chronic conjunctivitis Dacryocystitis Migrated punctal plug Pearls and Other Issues Canaliculitis is a
condition which is commonly misdiagnosed or diagnosed late. Each bone borders the frontal process
of the maxilla (see image) and the orbital plate of the frontal bone that forms the recessed area of the
eye socket at the top of the eye socket. Recent studies, however, demonstrate an increased incidence
of Staphylococcus and Streptococcus. Mattering on the eyelids, expression of yellowish granules,
concretions, and stones by massage are other presentations. The most common causative organisms
are the Actinomyces species, but recent studies indicate high rates of infection with streptococcal and
staphyloccal bacteria. All patients had successful dacryocystorhinostomy outcomes. While the
implants do not directly cause canaliculitis, they set the stage for opportunistic infection. It can occur
at any age ranging from 5 years to 90 years, and the mean age has been estimated to be about 59
years. Surv Ophthalmol. 2011 Jul-Aug;56(4):336-47.. Last accessed October 31, 2015. 2.
Canaliculitis. RevOptom. Handbook of Ocular Disease Management.. Last accessed August 21,
2014. 3. Dimmick T. Gurwood A. Disorders of the Nasolacrimal System. RevOptom.. Last accessed
August 21, 2014.