Chronic Canaliculitis Research Articles

Mini-invasive Therapy for Primary Chronic Canaliculitis without Damaging Lacrimal Punctum.

This study aimed to introduce a mini-invasive surgical approach without damaging lacrimal punctum for treating primary chronic canaliculitis (PCC). A retrospective analysis of 35 patients (35 eyes) suffering from PCC were recruited in the study. The surgery method is described briefly below: After making a conjunctival incision about 3-mm in length along the horizontal canaliculus at about 3-mm to the nasal of punctum, a curette of 2-mm diameter was used to evacuate the concretions through the incision of canaliculus. After evacuating all concretions, a silicon tube was inserted into the lacrimal duct through canaliculus to nasal cavity. With a follow-up of 12 months, all patients had resolution of symptoms of inflammation and no recurrent case was found. The anatomical success was achieved in 34 cases (97.1%). The functional success was achieved in 32 cases (91.4%). Key Words: Primary chronic canaliculitis, Mini-invasive, Silicone tube.

Canaliculotomy as A Canalicular Obstruction Management Approach: a Case Series

Lacrimal drainage obstruction is a common disorder of lacrimal system. This obstruction could affect lacrimal punctum, canaliculi, lacrimal sac, and lacrimal duct. The etiology could be congenital or acquired, such as triggered by infection or other conditions. This case series illustrates the procedure of canaliculotomy to reduce the epiphora symptom caused by lacrimal drainage obstruction, specifically in punctum and canaliculi. The aim of this case series was to report the management of punctal and canaliculi obstruction with canaliculotomy procedure. Case 1, an eighty-two years old woman with chronic canaliculitis on the right eye due to Actynomyces sp. infection, underwent canaliculotomy and curetage of canalicular area of the right eye. Case 2, a sixty-years old man with chronic canaliculitis with canalicular fistula on the left eye underwent canaliculotomy with silicone tube procedure on the left eye. Case 3, a sixty-seven years old man with recurrent punctal obstruction due to punctal stenosis of the left eye, previous punctoplasty, underwent canaliculotomy with silicone tube. Identification of the patient's symptoms is very important in determining the diagnosis and management plan for the patient. Canaliculotomy procedure with antimicrobial and steroid medication after procedure leads to a good result in reducing symptoms caused by lacrimal drainage obstruction due to various etiology.

Actinomyces Canaliculitis Complicated by Orbital Pyogenic Granuloma

Abstract A 92 year-old woman with no significant past ocular history presented with a one-year history of bloody tears, pruritus, and an enlarging supero-medial orbital mass with extension through the right upper eyelid punctum. Magnetic resonance imaging of the orbits demonstrated a well-circumscribed, ring enhancing mass of the right anterior supero-medial orbit. Medial orbitotomy and removal of the orbital mass was performed, and histopathology revealed lymphoid proliferation surrounding a microbial infiltrate staining for gram-positive filamentous bacteria with sulfur granules. Overall, the findings were consistent with chronic canaliculitis secondary to Actinomyces species complicated by formation of an orbital pyogenic granuloma. She has had no recurrence of disease at five months of follow-up. To the authors' knowledge, this case is only the second report of pyogenic granuloma as a complication of Actinomyces canaliculitis and the first associated with an orbital mass.

Actinomycotic lacrimal canaliculitis: a rare case report

Actinomyces israelii is a gram-positive anaerobic organism commonly associated with canaliculitis in adults. Actinomyces are normal commensal bacteria in humans and primarily cause opportunistic infections during immunosuppressive state or when loss of continuity of epithelial lining in mucosa occurs. Lacrimal canaliculitis is a relatively rare condition and is undiagnosed for long periods of time. Being a relatively rare condition, it is commonly overlooked and undiagnosed for long periods of time. Primary chronic canaliculitis is an uncommon problem and Actinomycosis may form in up to 2% of all lacrimal disease. Here present study reports a case of lacrimal canaliculitis caused by Actinomyces israelii.

Aggregatibacter aphrophilus chronic lacrimal canaliculitis: a case report

BackgroundChronic canaliculitis is often misdiagnosed as conjunctivitis, delaying proper documentation and management. Aggregatibacter aphrophillus has not been implicated in chronic canaliculitis.Case presentationWe report a case of unilateral chronic epiphora associated with chronic lacrimal canaliculitis resistant to prolonged topical antibiotic treatment in a 65-year-old woman without notable medical history. Canaculotomy, curettage with removal of concretions and tubing with silicone stent for six weeks resolved this chronic infection. Culturing lacrimal secretions and concretions yielded Aggregatibacter aphrophilus in pure culture. Histological analyses showed elongated seed clusters surrounded by neutrophils. Fluorescence in Situ Hybridization confirmed the presence of bacteria in two distinctive concretions.ConclusionThis first documented case of A. aphrophilus chronic lacrimal canaliculitis illustrates that optimal surgical management of chronic lacrimal canaliculitis allows for both accurate microbiological diagnosis and treatment.

Diagnosis of lacrimal canalicular diseases using ultrasound biomicroscopy: a preliminary study.

To evaluate the application of ultrasound biomicroscopy (UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states. Sixty cases (63 eyes, 69 canaliculi) of lacrimal canalicular diseases were enrolled that included 32 patients (32 eyes, 32 canaliculi) with chronic lacrimal canaliculitis, 18 patients (18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, 9 patients (12 eyes, 18 canaliculi) with congenital absence of lacrimal puncta and canaliculi, and 1 case (1 eye, 1 canaliculus) of canalicular mass. The patients were examined using UBM, and disease-specific features of the UBM images were noted. UBM imaging of lacrimal canaliculi in chronic canaliculitis patients showed obvious ectasia of the lacrimal canalicular lumen. Dot-like moderate echoic signals were detected on some ectatic lumina of the lacrimal canaliculus. Some lumen-like structures of the lower lacrimal canaliculus were observed in 2 (2 eyes, 2 canaliculi) of the 9 patients (12 eyes, 18 canaliculi) with congenital absence of the lacrimal canaliculus. Of the 18 patients (18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, the lacerated end on the nasal side of the lacrimal canaliculus was detected only in 14 patients (14 eyes, 14 canaliculi). UBM can be used to evaluate lacrimal canalicular diseases and can provide an imaging basis for the diagnosis of lacrimal canalicular diseases.

Lacrimal canaliculitis- A case report

Lacrimal canaliculitis is an infection of the lacrimal duct system. It is an uncommon, often misdiagnosed diagnosis because it can mimic many other common ocular conditions.The classic features of lacrimal canaliculitis are mild to severe swelling of the canaliculus, mucopurulent discharge from the punctum, and a red, pouting punctum.Canaliculitis should be appropriately diagnosed and treated to avoid recurrent inflammation and possible obstruction of the upper portion of the lacrimal system.However, Primary chronic canaliculitis may account for approximately 2% of all tearing problems. Actinomycosis may form in up to 2% of all lacrimal disease and can cause conjunctivitis or lacrimal canaliculitis with no generalized systemic invasion.Canaliculotomy with systemic or topical antibiotics is the most appropriate treatment for this disorder. We report a case of lacrimal canaliculitis in a 57years old female who presented in our opd with painless swelling of the right medial upper lid and occasional redness for 2 years. Despite surgical management being the definitive treatment , the patient was managed conservatively with no recurrence till date.

Diagnosis and Treatment of Chronic Canaliculitis

Diagnosis and Treatment of Chronic Canaliculitis

Canaliculite lacrymale à Actinomyces: À propos d'un cas

The authors report a case of unilateral chronic epiphora resistant to prolonged topical antibiotic treatment in a 62-year-old woman. Culture yielded some colonies of Actinomyces species. A dacryocystorhinostomy was found to be ineffective. Canaliculotomy with removal of cast resolved the chronic canaliculitis. Histological examination confirmed the diagnosis of solid cast of Actinomyces.

A Case Series on Chronic Canaliculitis

Introduction: Primary chronic canaliculitis is an uncommon disease, which is often misdiagnosed and insufficiently treated. We present two cases of canaliculitis caused by two different organisms, Actinomycetes spp. and Arcanobacterium haemolyticum. To the best of our knowledge, canaliculitis due to Arcanobacterium haemolyticum has not been reported before. Patients and Methods: The two cases described in this series show typical clinical features of canaliculitis with an inflamed upper canaliculus, not responsive to topical antibiotics. Appropriate treatment was delayed as they were initially treated for conjunctivitis. Both patients were treated with a canaliculotomy, with curettage and subsequent treatment with topical and systemic penicillin. The contents were sent for microbiological examination. Results: There was complete resolution following treatment. Actinomyces spp. was grown from one patient as expected. However, in the second patient, Arcanobacterium haemolyticum was isolated. Although this organism was not expected, the patient did respond to similar, conventional treatment. Discussion: Actinomyces spp. is a cast-forming Gram-positive anaerobe. They are difficult to isolate and identify and can cause infections of hollow spaces with formation of canaliculiths. Arcanobacterium (Corynebacterium) haemolyticum closely resembles Actinomyces (Corynebacterium) pyogenes. Ocular infections reported with this organism include orbital cellulitis and subperiosteal abscesses. The difficulty encountered in the isolation and identification of these organisms is discussed and the need for thorough curettage in the treatment of persistent or recurrent canaliculitis is emphasised. Conclusion: Chronic canaliculitis should be considered in any patient who presents with chronic or recurrent conjunctivitis. Definitive cure will not be affected until all concretions are removed, either at surgery or by mechanical expression.

Tratamento cirúrgico das canaliculites crônicas: relato de nossa experiência em 7 casos

Objetivo: Discutir as principais formas de tratamento existentes atualmente e relatar a nossa experiência com o tratamento cirúrgico das canaliculites crônicas. Métodos: Estudo retrospectivo com 7 casos atendidos na Clínica Oftalmológica do HC-FMUSP nos últimos 3 anos. Resultados: Todos os pacientes submetidos a tratamento cirúrgico tiveram cura completa dos sinais e sintomas. Conclusões: Devemos sempre lembrar da possibilidade de canaliculite em pacientes com queixa de epífora e secreção crônica no ponto lacrimal para que seja realizado o tratamento cirúrgico adequado.

Cast‐forming Actinomyces israelii canaliculitis

Primary chronic canaliculitis is an uncommon disease usually caused by Actinomyces israelii (streptothrix). Actinomyces israelii is a cast-forming Gram-positive anaerobe that is difficult to isolate and identify. We present a case that demonstrates the typical clinicopathological presentation of this unusual condition and discuss management options. A 10-year-old girl presented with a 6 month history of intermittent 'conjunctivitis' and discharge from her 'pouted' left lower punctum. Microbiology confirmed probable A. israelii infection, but topical treatment failed. Exploration under anaesthesia revealed a canalicular diverticulum and three canaliculiths. Histological examination of the canaliculiths demonstrated that they consisted of solid casts of Actinomyces. Punctoplasty, removal of the casts, and adjunct antibiotic therapy resulted in resolution of the canaliculitis. Primary chronic canaliculitis should be considered in any patient who presents with chronic or recurrent conjunctivitis and the eyelid should be inspected for a discharging and 'pouting' punctum. Failure of the condition to resolve on topical treatment requires surgical exploration of the canalicular system and removal of any casts. Extensive surgery is not always required.

Intubation dacryocystography in patients with a clinical diagnosis of chronic canaliculitis ("streptothrix").

Magnification dacryocystography in 18 patients with chronic infective canaliculitis showed dilatation and irregularity of the affected lacrimal canaliculi, with prominent filling defects in almost all cases. Filling defects are uncommon in other diseases of the canaliculi and serve to confirm the diagnosis.

OCULAR MANIFESTATIONS OF SJÖGREN’S SYNDROME: KERATOCONJUNCTIVITIS SICCA

As part of the triad of Sjögren's syndrome (SS), keratoconjunctivitis sicca (KCS) can be found in virtually all SS patients. This term emphasizes not only the reduced tear production but also the pathologic changes in the epithelial cells of the ocular surface. The symptoms of dry eye may vary from one patient to another depending on the severity of dryness, the ability of the diminished tear film to moisten the ocular surface, and the patient's tolerance for ocular discomfort. Treatment of the dry eyes is remarkably effective, and most patients benefit from moisturizing eyedrops to replace their own deficient tears. Major issues include the pathogenesis of decreased tear flow and ocular surface disturbances, as well as the roles of wound healing agents and anti-inflammatory medications in KCS therapy.

Thorough Curettage in the Treatment of Chronic Canaliculitis

While various techniques have been proposed for the treatment of canaliculitis, there have been no published series that evaluate the efficacy of simple curettage in the treatment of persistent or recurrent canaliculitis. We report the effectiveness of thorough, simple curettage (without canaliculotomy) in 11 patients with chronic canaliculitis. All patients had a history of canaliculitis-related symptoms for a minimum of 6 months and clinically detectable canalicular concretions before initial treatment. Thorough, simple curettage (without canaliculotomy) resolved the chronic canaliculitis in all of the patients. Ten of the 11 patients were cured with a maximum of two sessions of curettage. One patient required three treatments of curettage and silicone intubation for common canalicular narrowing to render her free of symptoms. No surgical complications occurred in any of the patients. Our report confirms the effectiveness and low morbidity of thorough curettage in the treatment of persistent or recurrent cases of canaliculitis.