Inflammation

Question 1

Chronic canaliculitis - cause

Answer 1

Actinomyces israelii, anaerobic Gram-positive bacteria

Question 2

Chronic canaliculitis - signs

Answer 2

unilateral epiphora associated with chronic mucopurulent conjunctivitis refractory. pericanalicular redness and oedema, and mucopurulent discharge on pressure over the canaliculus. A ‘pouting’ punctum. Concretions (sulfur granules).

Question 3

Chronic canaliculitis - treatment

Answer 3

topical fluoroquinolone combined with canaliculotomy (a linear incision into the conjunctival side of the canaliculus) and curettage of concretions

Question 4

Chronic canaliculitis - differentiation

Answer 4

Giant fornix syndrome, dacryolithiasis and lacrimal diverticulum

Question 5

Acute canaliculitis

Answer 5

Herpes simplex

Question 6

DACRYOCYSTITIS - causes

Answer 6

secondary to obstruction of the nasolacrimal duct. staphylococcal or streptococcal

Question 7

Acute dacryocystitis - treatment

Answer 7

warm compresses and oral antibiotics such as flucloxacillin or co-amoxiclav; irrigation and probing should not be performed. ○ Incision and drainage may be considered if pus points → risk of a persistent sac–skin fistula. DCR after infection

Question 8

Chronic dacryocystitis - signs

Answer 8

chronic epiphora, which may be associated with a chronic or recurrent unilateral conjunctivitis

Question 9

mucocoele - signs

Answer 9

painless swelling, but if an obvious swelling is absent pressure over the sac commonly still results in mucopurulent canalicular reflux

Question 10

Chronic dacryocystitis / mucocoele - treatment

Answer 10

DCR