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Primary lacrimal canaliculitis - A clinical entity often misdiagnosed.
J Curr Ophthalmol 2018; 30(1):87-90JC

Abstract

Purpose

Primary lacrimal canaliculitis (PLC) is a unique disorder which often gets misdiagnosed by the general as well as speciality-trained ophthalmologists. Elderly patients with history of chronic or recurrent epiphora with discharge, often get mislead towards chronic dacryocystitis. The aim of our report is to discuss the misleading diseases in our PLC patients and to revisit this hidden disease.

Methods

The patients of PLC who were previously misdiagnosed were studied. The clinical history, presenting clinical features, misdiagnosis, and final management of the patients is described.

Results

There were 5 misdiagnosed female patients. A history of chronic redness, watering, discharge, and medial canthal region edema lead to the misdiagnosis of chronic dacryocystitis in 3 (60%) and medial marginal chalazion in 2 (40%) cases. Slit-lamp examination revealed localized hyperemia (n = 5), classical pouting of lacrimal punctum (n = 3), and expressible purulent discharge (n = 3). Two patients without punctum pouting had an explicit yellowish hue/discoloration of the canalicular region. Our patients had a mean 4 visits before an accurate diagnosis. Three-snip punctoplasty with canalicular curettage was performed in three while two were managed conservatively. At last follow-up, all patients were symptom-free with punctum and canalicular scarring in three, who underwent surgery.

Conclusion

PLC is a frequently misdiagnosed clinical entity which delays the initiation of appropriate treatment. A succinct magnified examination of punctum and canalicular region can provide sufficient clues pivotal for accurate diagnosis.

Authors+Show Affiliations

Post Graduate Institute of Medical Education and Research, Chandigarh, India.Post Graduate Institute of Medical Education and Research, Chandigarh, India.Post Graduate Institute of Medical Education and Research, Chandigarh, India.Sankara Eye Hospital, Ludhiana, Punjab, India.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

29564416

Citation

Singh, Manpreet, et al. "Primary Lacrimal Canaliculitis - a Clinical Entity Often Misdiagnosed." Journal of Current Ophthalmology, vol. 30, no. 1, 2018, pp. 87-90.
Singh M, Gautam N, Agarwal A, et al. Primary lacrimal canaliculitis - A clinical entity often misdiagnosed. J Curr Ophthalmol. 2018;30(1):87-90.
Singh, M., Gautam, N., Agarwal, A., & Kaur, M. (2018). Primary lacrimal canaliculitis - A clinical entity often misdiagnosed. Journal of Current Ophthalmology, 30(1), pp. 87-90. doi:10.1016/j.joco.2017.06.010.
Singh M, et al. Primary Lacrimal Canaliculitis - a Clinical Entity Often Misdiagnosed. J Curr Ophthalmol. 2018;30(1):87-90. PubMed PMID: 29564416.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary lacrimal canaliculitis - A clinical entity often misdiagnosed. AU - Singh,Manpreet, AU - Gautam,Natasha, AU - Agarwal,Aniruddha, AU - Kaur,Manpreet, Y1 - 2017/07/19/ PY - 2017/03/26/received PY - 2017/05/17/revised PY - 2017/06/25/accepted PY - 2018/3/23/entrez PY - 2018/3/23/pubmed PY - 2018/3/23/medline KW - Chronic dacryocystitis KW - Lacrimal canaliculus KW - Lacrimal punctum KW - Misdiagnosis KW - Primary lacrimal canaliculitis SP - 87 EP - 90 JF - Journal of current ophthalmology JO - J Curr Ophthalmol VL - 30 IS - 1 N2 - Purpose: Primary lacrimal canaliculitis (PLC) is a unique disorder which often gets misdiagnosed by the general as well as speciality-trained ophthalmologists. Elderly patients with history of chronic or recurrent epiphora with discharge, often get mislead towards chronic dacryocystitis. The aim of our report is to discuss the misleading diseases in our PLC patients and to revisit this hidden disease. Methods: The patients of PLC who were previously misdiagnosed were studied. The clinical history, presenting clinical features, misdiagnosis, and final management of the patients is described. Results: There were 5 misdiagnosed female patients. A history of chronic redness, watering, discharge, and medial canthal region edema lead to the misdiagnosis of chronic dacryocystitis in 3 (60%) and medial marginal chalazion in 2 (40%) cases. Slit-lamp examination revealed localized hyperemia (n = 5), classical pouting of lacrimal punctum (n = 3), and expressible purulent discharge (n = 3). Two patients without punctum pouting had an explicit yellowish hue/discoloration of the canalicular region. Our patients had a mean 4 visits before an accurate diagnosis. Three-snip punctoplasty with canalicular curettage was performed in three while two were managed conservatively. At last follow-up, all patients were symptom-free with punctum and canalicular scarring in three, who underwent surgery. Conclusion: PLC is a frequently misdiagnosed clinical entity which delays the initiation of appropriate treatment. A succinct magnified examination of punctum and canalicular region can provide sufficient clues pivotal for accurate diagnosis. SN - 2452-2325 UR - https://www.unboundmedicine.com/medline/citation/29564416/Primary_lacrimal_canaliculitis___A_clinical_entity_often_misdiagnosed_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2452-2325(17)30074-4 DB - PRIME DP - Unbound Medicine ER -