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Dacryoadenitis

Dacryoadenitis is an inflammation of the tear-producing gland (lacrimal gland).

Causes, incidence, and risk factors

Acute dacryoadenitis is most commonly due to viral or bacterial infection. Common causes include mumps , Epstein-Barr virus , staphylococcus, and gonococcus.

Chronic dacryoadenitis is usually due to noninfectious inflammatory disorders. Examples include sarcoidosis , thyroid eye disease, and orbital pseudotumor .

Symptoms

  • Swelling of the outer portion of the upper lid, with possible redness and tenderness
  • Pain in the area of swelling
  • Excess tearing or discharge
  • Swelling of lymph nodes in front of the ear

Signs and tests

Dacryoadenitis can be diagnosed by examination of the eyes and lids. Special tests such as a CT scan may be required to search for the cause. Sometimes biopsy will be needed to be sure that a tumor of the lacrimal gland is not present.

Treatment

If the cause of dacryoadenitis is a viral condition such as mumps, simple rest and warm compresses may be all that is needed. For other causes, the treatment is specific to the causative disease.

Expectations (prognosis)

Most patients will fully recover from dacryoadenitis. For conditions with more serious causes, such as sarcoidosis, the prognosis is that of the underlying condition.

Complications

Swelling may be severe enough to put pressure on the eye and distort vision. Some patients first thought to have dacryoadenitis may turn out to have a malignancy of the lacrimal gland.

Calling your health care provider

Call your health care provider if swelling or pain increase despite treatment.

Prevention

Mumps can be prevented by immunization. Infection with gonococcus, the bacteria causing gonorrhea, can be avoided by the use of safe sex practices. Most other causes cannot be prevented.

References

Karesh JW, On AV, Hirschbein MJ. Noninfectious orbital inflammatory disease. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 35.

Durand ML. Periocular infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 114.

Updated: 9/3/2012

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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