Canaliculitis

Canaliculitis Canaliculitis is a rare inflammatory condition affecting the canaliculi, which are small channels in the eyelids that drain tears from the eye into the lacrimal sac. This condition is often misdiagnosed due to its rarity and the subtlety of its symptoms.

Etiology

Canaliculitis is most commonly caused by an infection. The primary infectious agent is the bacterium Actinomyces israelii, although other bacteria, fungi, and viruses can also be responsible. Actinomyces is a gram-positive bacterium that is part of the normal flora of the mouth and throat but can cause infection when it invades the canaliculi.

Clinical Presentation

Patients with canaliculitis typically present with chronic tearing (epiphora), discharge, and redness of the affected eye. A key feature is the presence of a pouting punctum, where the opening of the canaliculus appears swollen and inflamed. Expressing the canaliculus may yield a yellowish discharge, sometimes containing sulfur granules, which are characteristic of Actinomyces infection.

Diagnosis

Diagnosis of canaliculitis is primarily clinical, based on the symptoms and physical examination findings. However, microbiological cultures of the discharge can help identify the causative organism. Imaging studies, such as dacryocystography, are rarely needed but can be used to assess the extent of the infection.

Treatment

The treatment of canaliculitis involves both medical and surgical approaches. Initial management includes warm compresses and topical antibiotics. However, due to the chronic nature of the infection and the presence of concretions, surgical intervention is often necessary. Canaliculotomy, a procedure where the canaliculus is incised and the contents are expressed, is the definitive treatment.

Prognosis

With appropriate treatment, the prognosis for canaliculitis is generally good. Recurrence is possible if the infection is not completely eradicated, so thorough surgical cleaning is essential.

Prevention

Preventive measures are not well-defined due to the rarity of the condition. Maintaining good eyelid hygiene and addressing any underlying conditions that may predispose to infection can be beneficial.

See Also

• Dacryocystitis
• Blepharitis
• Conjunctivitis

External Links

• [Link to a reputable medical resource on canaliculitis]

NIH genetic and rare disease info

• NIH info on Canaliculitis

Canaliculitis is a rare disease.