Introduction:

Canaliculitis is an uncommon but potentially serious infection of the canaliculi, which are the small channels that carry tears from the eye to the nose. This comprehensive article aims to provide a detailed overview of canaliculitis, including its causes, symptoms, diagnostic methods, and available treatment options.

Understanding Canaliculitis:

Canaliculitis is characterized by the inflammation and infection of one or both canaliculi. The infection is usually caused by bacteria, most commonly Actinomyces israelii or Pseudomonas aeruginosa. The condition may lead to blockage of the canaliculi, preventing proper tear drainage and causing eye discomfort.

Causes of Canaliculitis:

Canaliculitis is typically caused by bacterial infection. The bacteria can enter the canaliculi through various means, including:

• Spontaneous Infection: In some cases, canaliculitis may develop without a clear source of infection.
• Obstruction: Obstruction of the canaliculi can lead to a buildup of tears, creating a favorable environment for bacterial growth.
• Dacryoliths: Dacryoliths are small calcified stones that can form in the canaliculi, serving as a nidus for bacterial infection.

Symptoms of Canaliculitis:

Canaliculitis may present with the following signs and symptoms:

• Pain and Tenderness: The affected eye may be painful and tender, especially when pressure is applied to the inner corner of the eye.
• Epiphora: Excessive tearing due to partial or complete blockage of the canaliculi.
• Discharge: A sticky or purulent discharge may be present, often with a foul odor.
• Redness and Swelling: The area around the inner corner of the eye may appear red and swollen.
• Crusting of the Eyelids: The presence of discharge may cause crusting of the eyelids, especially after sleep.

Diagnosis of Canaliculitis:

Diagnosing canaliculitis involves a comprehensive eye examination, and the following methods may be used:

• Canalicular Irrigation: Irrigation of the canaliculi with saline solution can help identify blockages or dislodged dacryoliths.
• Swab Culture: A sample of the discharge may be collected and sent for laboratory culture to identify the causative bacteria.
• Imaging Studies: In some cases, imaging studies such as dacryocystography or dacryoscintigraphy may be performed to assess the tear drainage system.

Treatment of Canaliculitis:

Treatment for canaliculitis aims to eradicate the bacterial infection and restore proper tear drainage. Treatment options may include:

• Antibiotics: Antibiotic eye drops or ointments are usually prescribed to treat the bacterial infection. In severe cases, oral antibiotics may be necessary.
• Canalicular Lavage: The canaliculi may be flushed with saline solution to remove debris and discharge.
• Dacryocystorhinostomy (DCR): In cases of persistent or recurrent canaliculitis, a surgical procedure called DCR may be performed to create a new drainage pathway for tears, bypassing the affected canaliculi.

Conclusion:

Canaliculitis is a rare but significant infection that affects the tear drainage system. Early diagnosis and appropriate treatment are crucial for managing the infection, preserving tear drainage, and preventing complications.

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