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Definition:
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Dacryoadenitis is an inflammation of the tear-producing gland (lacrimal gland).
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Causes, incidence, and risk factors:
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Acute dacryoadenitis is most commonly due to viral or bacterial infection. Common causes include mumps, Epstein-Barr virus, staphylococcus, and gonococcus.
Chronic dacryoadenitis is usually due to noninfectious inflammatory disorders. Examples include sarcoidosis, thyroid eye disease, and orbital pseudotumor.
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Symptoms:
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- Swelling of the outer portion of the upper lid, with possible redness and tenderness
- Pain in the area of swelling
- Excess tearing or discharge
- Swelling of lymph nodes in front of the ear
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Signs and tests:
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Dacryoadenitis can be diagnosed by examination of the eyes and lids. Special tests such as a CT scan may be required to search for the cause. Sometimes biopsy will be needed to be sure that a tumor of the lacrimal gland is not present.
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Treatment:
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If the cause of dacryoadenitis is a viral condition such as mumps, simple rest and warm compresses may be all that is needed. For other causes, the treatment is specific to the causative disease.
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Expectations (prognosis):
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Most patients will fully recover from dacryoadenitis. For conditions with more serious causes, such as sarcoidosis, the prognosis is that of the underlying condition.
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Complications:
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Swelling may be severe enough to put pressure on the eye and distort vision. Some patients first thought to have dacryoadenitis may turn out to have a malignancy of the lacrimal gland.
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Calling your health care provider:
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Call your health care provider if swelling or pain increase despite treatment.
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Prevention:
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Mumps can be prevented by immunization. Infection with gonococcus, the bacteria causing gonorrhea, can be avoided by the use of safe sex practices. Most other causes cannot be prevented.
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References:
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Karesh JW, On AV, Hirschbein MJ. Noninfectious orbital inflammatory disease. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 35.
Durand ML. Periocular infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 114.
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