The size of the glands is almost the size of an almond from which tears are produced and any irritation to the large tear glands can lead to inflammation and swelling.

Although there is no exact record, a study has estimated that 1 in 10 eye patients may experience lachryoadenitis during their lifetime.

“The discomfort from the inflammation can be transient or persistent, but if not treated promptly and correctly, there is a possibility that it will develop into a serious disease that will cause damage to the patient’s eye,” points out Mrs. Dimitra Portaliou Ophthalmologist Surgeon – Ophthalmologist, Director of the Second Ophthalmology Clinic in the Metropolitan Hospital and continues with what is associated with this rare but serious eye condition:

Forms of lachryoadenitis

“Dacryoadenitis is distinguished in acute and years tells and explains each form.

• Acute lacryadenitiswe have when it manifests within a few hours or days, on the one hand, only with severe symptoms, such as pain, redness, swelling of the conjunctiva, swelling of the upper eyelid, purulent secretions, while signs of upper respiratory infection, fever, swelling of the parotid glands and swollen lymph nodes.
• Chronic lacryadenitis, we have when the swelling lasts for more than a month on both sides. The symptomatology is not intense, there is no pain, but there may be symptoms of dry eyes. However, in very severe cases the lacrimal gland may protrude beyond the eyelid into the outer upper part of the eye.”

What causes lachryoadenitis?

Lacrimal gland disorder is usually caused by either inflammation or an autoimmune disease (such as Graves’ disease of the thyroid gland) or may be an underlying malignancy such as lymphoma. When it occurs unexpectedly, it is usually caused by a bacterial or viral infection. In very rare cases, the infection can also be caused by fungi or parasites. In even rarer cases, as reported in the medical literature (there are few reports), o coronavirus SARS-CoV-2 may be the factor causing the inflammation.

Symptoms of lachryoadenitis

“Inflammation of the lacrimal gland can cause swelling around the upper, outer corner of the eye, causing drooping of the eyelid, tearing, swollen lymph nodes near the ear, redness of the eye and a burning sensation. Patients may also feel pain when moving the affected eye. There may be ecchymosis with corresponding hyposphagma in the conjunctiva of the eye.

Usually, lacryadenitis does not affect vision. However, in cases where the swelling is large enough and presses on the eye, it can cause a disturbance in this function as well or even diplopia. If you notice unusual changes in one or both eyes, such as pain, swelling or a change in color, it is recommended that you see your doctor.
Also if you notice a sudden decrease or loss of vision, rapid worsening of swelling in the eye, severe pain and/or you start to see “lights” or “flies” in your field of vision, you must visit the doctor immediately to stop the progression of the disease” emphasizes Mrs. Portaliou.

How is the diagnosis made?

“The diagnosis of lachryoadenitis can be made based on medical history and clinical examination. In the event that the patient has received corticosteroids before the examination, the cortisone can be an inhibiting factor in finding clinically critical findings of the condition, mainly the swelling and swelling of the associated lymph nodes. Blood tests may also be needed to check various markers of inflammation. While at the same time, a biopsy may be requested on the lacrimal gland, to rule out the possibility of a lump inside it, but also to carry out imaging tests, such as CT and MRI,” he says.

How is lachryoadenitis treated and how long does it take?

“When lachryoadenitis is acute, antiviral drugs or antibiotics for bacterial infections may be required. It is vital that patients take the medications recommended by their ophthalmologist consistently and for as long as needed. Even if the symptoms weaken or disappear completely, they should not stop treatment prematurely, as there is a risk of relapse. Most likely, in a second relapse, the infection will be more intense than initially.

Treatment of chronic lachryoadenitis usually depends on controlling the underlying autoimmune condition. The doctor may also prescribe corticosteroid medications (cortisone) to treat inflammation and swelling in the eye. Regardless of whether the lachryoadenitis is acute or chronic, the patient can take additional measures to relieve themselves, such as resting the eyes and using warm patches (compresses) as well as using pain relievers.

The ophthalmologist will give instructions on how often and for how long the warm pads should be used,” explains the specialist and adds:
“Typically, acute lachryoadenitis resolves completely in 4-6 weeks, however chronic can persist and recur. The progress of recovery depends on the timely initiation of treatment, the cause of the infection and the existing state of health.”

Is there a case of hospitalization for lachryadenitis?

“If treatment is delayed or not applied correctly, there is a risk of developing an abscess in the eye or inflammation of the cells (cellulitis). In such cases, the patient should be closely monitored in the hospital and receive intravenous antibiotic therapy. At the same time, surgery may be required to open the abscess,” explains the doctor.

How can I prevent the appearance of inflammation?

“The best practice is to observe the rules of hygiene, with frequent hand washing and avoiding touching the eyes with dirty hands. However, if you have an autoimmune disease that can cause lachryoadenitis, it may not be possible to prevent it,” concludes Ms Portaliu.

* The Metropolitan Hospital has developed an Ophthalmology department which operates according to the standards of ophthalmology centers at an international level. It has experienced and specialized surgeons and staff that provide comprehensive medical services, including psychological support. The equipment is state-of-the-art, with state-of-the-art machines and systems that ensure accurate diagnosis and the provision of effective treatment. The operating theaters are equipped to deal with any incident, whether planned or emergency surgery, with excellent technique and nursing support.