bubble_chart Overview

Chronic dacryoadenitis is more common clinically than acute dacryoadenitis and is often associated with systemic infections.

bubble_chart Etiology

Mostly primary, it can also develop from acute conditions. The progression is slow, and the lesions are often bilateral. The glandular tissue gradually enlarges, causing a painless swelling on the upper outer side of the eyelid, though it may be tender to touch. The mass may also feel lobulated, accompanied by displacement of the eyeball downward and inward, limited upward movement, resulting in diplopia or leading to drooping of the upper eyelid (blepharoptosis).

bubble_chart Clinical Manifestations

1. Subcutaneous node dacryoadenitis: One of the most common types, spread via the bloodstream, causing unilateral or bilateral swelling, painless, accompanied by preauricular lymph node enlargement. Often presents as an isolated subcutaneous node tumor. Most cases can self-heal. However, some may develop caseous necrosis, forming a cold abscess. After breaking through the skin, it forms a subcutaneous node fistula.

2. Prickly-ash-like sore (trachoma) dacryoadenitis: The effect of prickly-ash-like sore (trachoma) on the lacrimal gland may have two aspects: one is that during the scarring process of prickly-ash-like sore (trachoma), it causes obstruction of the lacrimal gland's drainage ducts, leading to secondary atrophy of the lacrimal gland; the other is that the prickly-ash-like sore (trachoma) virus invades the lacrimal gland along the excretory ducts, forming prickly-ash-like sore (trachoma) dacryoadenitis, but this needs to be fully confirmed.

3. Lacrimal gland fleshy tumor nodular tumor: A granulomatous inflammation that erodes the reticuloendothelial system, the cause of which is still unclear, often a local symptom of a systemic disease, mostly occurring in patients between 20 and 40 years old, bilateral but not necessarily simultaneous onset, the lacrimal gland shows gradual swelling, presenting as a painless nodule, firm in texture, connected to the orbital tissue but can be freely moved under the skin and orbital rim, final diagnosis requires biopsy.

4. Mikulicz's disease: Typically a chronic inflammation with bilateral lacrimal and parotid gland swelling, mostly occurring over the age of 30, but can occur at any age, disease cause unknown, most start slowly, but can also occur acutely. Initially unilateral, then bilateral. Not accompanied by pain or systemic reactions. Lacrimal gland swelling is symmetrical, soft, movable, elastic, non-tender, sometimes accompanied by hepatosplenomegaly and systemic lymph node enlargement symptoms. Often, simultaneously or within weeks or years, the parotid glands begin to swell symmetrically, sometimes invading the accessory lacrimal glands and glands, reducing saliva secretion, leading to dryness of the oral, nasal, and pharyngeal mucous membranes.

In chronic inflammation of the lacrimal and parotid glands, accompanied by subcutaneous nodes, leukemia, lymphoma, fleshy tumor nodules, or uveitis, parotid fever, it is called Mikulicz's syndrome.

bubble_chart Treatment Measures

Treatment for disease causes includes administering antibiotics, corticosteroids, sodium salicylate, and X-ray irradiation. A dacryoadenectomy may be performed if necessary.