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CONJUNCTIVITIS SECONDARY TO DACRYOCYSTITIS OR CANALICULITIS

CONJUNCTIVITIS SECONDARY TO DACRYOCYSTITIS

Both pneumococcal conjunctivitis (often unilateral and unresponsive to treatment) and beta-hemolytic streptococcal conjunctivitis (often hyperacute and purulent) may be secondary to chronic dacryocystitis. The nature and source of the conjunctivitis in both instances are often missed until the lacrimal system is investigated.

CONJUNCTIVITIS SECONDARY TO CANALICULITIS

Canaliculitis due to canalicular infection with Actinomyces israelii or Candida species (or, very rarely, Aspergillus species) may cause unilateral mucopurulent conjunctivitis, often chronic. The source of the condition is often missed unless the characteristic hyperemic, pouting punctum is noted. Expression of the canaliculus (upper or lower, whichever is involved) is curative provided the entire concretion is removed.

Conjunctival scrapings show a predominance of polymorphonuclear cells. Cultures (unless anaerobic) are usually negative. Candida grows readily on ordinary culture media, but almost all of the infections are caused by A israelii, which requires an anaerobic medium.

10.1036/1535-8860.ch5

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