J Korean Ophthalmol Soc.  2013 Oct;54(10):1481-1487.

Diagnosis and Treatment of Chronic Canaliculitis

• Park JH
• Roh JH

Abstract

PURPOSE
To report on the clinical manifestations, species and treatments of patients with chronic canaliculitis.
METHODS
From August 2003 to February 2012, 77 eyes of 77 patients who were diagnosed with chronic canaliculitis at our hospital were retrospectively analyzed.
RESULTS
The mean period from the onset of symptoms to diagnosis was 4.7 months. The most common systemic disease associated with chronic canaliculitis was diabetes (18 eyes, 23%), and 13 eyes (17%) were related to punctual plug insertion. Main symptoms consisted of epiphora with discharge and pouting punctum. In the culture results of 55 eyes, streptococci, staphylococci, and actinomyces among other bacteria were identified. Seventy-two eyes (94%) were cured with one-snip punctoplasty with curettage.
CONCLUSIONS
Chronic canaliculitis is rare, and the clinical aspect can be obscured by chronic conjunctivitis, thus the diagnosis is often delayed. In patients who have systemic diseases such as diabetes or past history of punctual plug insertion, chronic canaliculitis should be differentiated by observing the punctum more closely. If the diagnosis is accurate at the time, chronic canaliculitis could be easily cured by a relatively simple procedure such as one-snip punctoplasty with curettage.

Keyword

Chronic Canaliculitis; One-snip punctoplasty; Punctal plug

MeSH Terms

Actinomyces
Bacteria
Conjunctivitis
Corneal Ulcer
Curettage
Dacryocystitis
Eye
Humans
Lacrimal Apparatus Diseases
Retrospective Studies
Canaliculitis

Figure

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  Figure 1. (A) Pouting punctum, Injection of the conjunctiva could be misdiagnosed as chronic recurrent conjunctivitis. (B) Mucopurulent punctual regurgitation. (C) Peripunctal erythematous swelling. (D) Pyogenic granuloma.

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  Figure 2. SmartPLUG recovered after one-snip punctoplasty and curettage.

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  Figure 3. (A) Freeman-type punctal plugs were eliminated from the left lower punctum. (B) This picture shows the removed Freeman-type punctal plugs. Note the two Freeman-type punctal plugs had been inserted in the same punctum.

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  Figure 4. (A, B) Intracanalicular concretion.

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  Figure 5. (A) Photograph showing the punctum of a patient with recurrent canaliculitis. (B) Two weeks after punctoplasty and curettage, the signs of canaliculitis had resolved completely.

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