Dacryoadenitis

Dacryoadenitis is is an inflammation of the lacrimal gland. It can be acute or chronic.

Clinical presentation

Initial symptoms of dacryoadenitis include:

• discomfort in the region of the gland (superolateral orbit)

• pain (occasional) ³

In severe cases, there may be:

• swelling, tenderness, a local rise of temperature and redness adjacent to lacrimal gland area

• dry eyes (due to impaired function of the lacrimal glands) ³ 

In chronic cases there may be:

• slow enlargement of glands over months to years

• irregularity of gland on palpation ³

Pathology

Etiology

Dacryoadenitis may be the result of infectious or inflammatory causes ^3,5. 

Acute infection of the lacrimal gland results in diffuse homogeneous enlargement, which can sometimes compress the globe. Most common organisms are Staphylococcus aureus, and viruses, including mumps, infectious mononucleosis (EBV), and influenza.

Inflammatory causes include IgG4-related disease, idiopathic orbital inflammation (orbital pseudotumor), and Sjögren syndrome.

Radiographic features

CT

CT demonstrates enlarged lacrimal glands at the superolateral aspect of orbit, compressing other orbital structures. CT can also be used to identify any other orbital abnormalities associated with dacryoadenitis.

Treatment and prognosis

Treatment depends on the underlying etiology. Empirical treatment with antibiotics may be considered. In viral dacryoadenitis, supportive treatment is required. This may include topical cool compresses, analgesics and antipyretics. EBV dacryoadenitis responds to steroids ⁴.