Eye Disease

Lacrimal canaliculitis (also called canniculitis) is when the tear (lacrimal) drainage system, specifically, the canaliculus, gets inflamed, causing a blockage. This blockage causes the tears in your eye to reflux back into the eye, spilling over and causing watery eyes (epiphora). It is an infection that can be caused by bacteria, fungi, or viruses. Canaliculitisoften has more symptoms than watery eyes, although that is one sign and symptom of the infection.

Symptoms of Canaliculitis   

Symptoms of Canaliculitis include:-

• Watery Eyes
• Red eyes
• Discharge
• Tenderness on the affected side (or both sides if both eyes are involved)

Causes of Canaliculitis

There are three major causes of Canaliculitis :-

•    Bacterial: The most common bacteria found in cases of canaliculitis are Actinomyces israelii, although other bacteria can be responsible for the infection.

•    Viral: The most common viral infection that causes canaliculitis is a herpetic infection – namely, the herpes simplex virus.

•    Fungal: Fungal infections associated with canaliculitis are rare, but when they do occur, the culprits are typically candida or aspergillus.

Treatment of Canaliculitis

Treatment of canaliculitis is typically successful when caught early enough. This is why it’s so important to see your therapeutic optometrist as soon as you notice symptoms such as watery eyes. Treatment of canaliculitis is twofold, consisting of physical removal of associated foreign matter and vigorous antimicrobial therapy. Small dacryoliths and other debris may be expressed through the punctum with direct manipulation using a cotton-tipped applicator. Larger or numerous stones often require surgical canaliculotomy.

Institute antimicrobial therapy only after alleviating the blockage. Treatment options depend on the offending agent. Obtain smears and cultures from the extruded canalicular material. In cases of bacterial infection, irrigate the canaliculus with penicillin G solution (100,000 units/ml). Usually, you will then follow-up with topical therapy (Polytrim or Neosporin ophthalmic solution) and systemic antibiosis (penicillin or ampicillin) for 1-2 weeks. Treatment for herpetic infection consists of topical trifluridine 1% five times daily for 2-3 weeks. Address fungal infections by using nystatin 1:20,000 ophthalmic solution tid, as well as biweekly nystatin irrigation.

Topics Covered

1. Lacrimal canaliculitis (also called canniculitis)
2. Symptoms of Canaliculitis 
3. Causes of Canaliculitis
4. Bacterial
5. Viral
6. Fungal
7. Treatment of Canaliculitis