Canaliculitis Awareness

Abstract

Objectives: To evaluate the demographic characteristics, treatment, and results of patients with canaliculitis.

Materials and methods: Medical records including the demographic characteristics, clinical findings, and treatment outcomes of patients diagnosed and treated for canaliculitis between September 2009 and March 2014 were analyzed retrospectively.

Results: The median age of the 7 canaliculitis patients consisting of 4 women and 3 men was 49 (range 8-58) years. All patients had unilateral canaliculitis (on the right side in 2 and left side in 5 patients) and the inferior canaliculus was involved more frequently (71.4%). Epiphora, chronic conjunctivitis, a palpable and thickened canaliculus, and yellow discharge from the punctum were present in all cases. Actinomyces spp. was the most frequently cultured microorganism (75%). Dacryolith was observed in 6 patients. Canaliculotomy and dacryolith removal with canalicular curettage were performed, followed by medical treatment (topical penicillin 100,000 U/ml and oral ampicillin/sulbactam) for 10 days. Patients were followed up for a mean duration of 17.0±15.2 (range 3-46) months. Signs and symptoms resolved completely within a month. Epiphora recurred in the 36th month in a single patient and was treated with daily canalicular irrigation with antibiotics and there were no further symptoms during 10 months of follow-up after the recurrence.

Conclusion: Canaliculitis is often overlooked and can be misdiagnosed. Every patient with chronic conjunctivitis and lacrimal infection should be examined carefully for canaliculitis.

Keywords: Canaliculitis; canaliculotomy; conjunctivitis; curettage.

Figure 1. (a) Findings of purulent discharge from the right inferior punctum and hyperemia of the nasal conjunctiva in a patient with right inferior canaliculitis; (b) macroscopic appearance of the sulfur granules after inferior canaliculotomy and curettage; (c) 100x magnification of Gram staining showing infiltration of Actinomyces colonies; (d) patient’s appearance 6 months after surgery

Figure 2. A patient with canaliculitis due to an eyelash entering the left inferior canaliculus