Dacryoadenitis

DACRYOADENITIS, dacryoadenitis (from the Greek dacryon - tear and aden - gland), inflammation of the lacrimal gland. This rare disease is observed in acute and chronic forms. In acute dacryoadenitis, a painful inflammatory swelling develops in the outer half of the upper eyelid. Upon everting the eyelid (especially when the patient looks downward) in the upper outer fornix of the conjunctiva, a sensitive, dense swelling (the inflamed gland) is discovered, covered by strongly edematous and hyperemic conjunctiva. Diffuse conjunctivitis with mucopurulent discharge is often also present. Within a few days, with intensifying pain and an increase in all inflammatory phenomena, the disease reaches its peak, and then regression of the process begins. In other cases, the matter leads to suppuration, with the opening of the abscess through the conjunctiva of the fornix, or more rarely through the skin. Acute dacryoadenitis is the result of infections of the lacrimal gland. In acute infectious conjunctivitis, the lacrimal gland remains unaffected. However, recently, changes in the lacrimal gland (usually insignificant) have also been described in conjunctivitis, especially in trachoma (Mihail). Lesions of the lacrimal gland in the overwhelming majority of cases occur via the endogenous pathway in various general infections, mainly in mumps (bilateral dacryoadenitis). Independently developing dacryoadenitis also apparently represents a local manifestation of a latently proceeding general infection. In chronic dacryoadenitis, inflammatory phenomena are absent, and the disease is expressed in the gradual enlargement of one or both glands, which leads to swelling in the outer half of the upper eyelid and to the formation of a dense, uneven mass in the upper outer fornix of the conjunctiva. With strong enlargement of the gland, displacement of the eyeball is possible. Chronic dacryoadenitis for the most part is not the outcome of an acute process and usually develops from the very beginning as such, arousing suspicion of a tumor. Therefore, removal of the enlarged glands was frequently performed, and in the majority of cases, especially with bilateral involvement, tuberculosis was found. Occasionally the changes were syphilitic in character. In Mikulicz's disease, both lacrimal glands are affected simultaneously with the salivary glands. To resolve the question of treatment, it is necessary to accurately determine the etiology. In acute infectious forms - local heat (best in the form of warming compresses), salicylic preparations, urotropin.