Lid/Orbit
Acute Dacryoadenitis
Also known as: lacrimal gland infection, upper outer lid swelling
Filed as: Urgent
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
OptoGuide™ supports professional judgement and does not diagnose or replace clinician responsibility.
Overview
Acute inflammation of the lacrimal gland causing upper outer lid swelling and tenderness.
Recognition
Symptoms: what patients report
- Upper outer lid pain and swelling
- Tenderness
- Redness
Signs: what the examination shows
- S-shaped ptosis pattern
- Superotemporal lid fullness
- Localised tenderness
- Conjunctival injection, with or without chemosis, over the lateral globe.
- Regional lymphadenopathy, no purulent discharge and a course of weeks point to Epstein-Barr virus, described in young adults (Rhem 2000); purulent discharge into the upper fornix points to bacterial infection, including MRSA (Liu 2014).
What OptoGuide™ covers for acute dacryoadenitis
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked New Zealand therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Dacryoadenitis — StatPearls, NCBI Bookshelf
- Anterior Eye Disease and Therapeutics A-Z (Bruce & Loughnan) — standard reference text
- Case 18-2015. Freitag SK, Cunnane ME, Yoon MK, et al. The New England Journal of Medicine. 2015;372(24):2337-45.
- Clinical characteristics, radiologic features, and histopathology of biopsied lacrimal gland tumors. Aryasit O, Amornthatree P, Tsutsumi WD, et al. Scientific Reports. 2023;13(1):16615.
- The "Wedge Sign": An Imaging Sign for Aggressive Lacrimal Gland Disease. Lorenzano D, Rose GE. Ophthalmology. 2017;124(7):1081-1083.
- Acute suppurative bacterial dacryoadenitis: a case series. Goold LA, Madge SN, Au A, et al. Br J Ophthalmol. 2013;97(6):735-8.
- Bacterial Dacryoadenitis With Abscess: Meta-Analysis of Features and Outcomes of a Rare Clinical Entity. Pietris J, Quigley C, Lam L, Selva D. Ophthalmic Plast Reconstr Surg. 2025;41(6):629-633.
- Epstein-Barr virus dacryoadenitis. Rhem MN, Wilhelmus KR, Jones DB. Am J Ophthalmol. 2000;129(3):372-5.
- Methicillin-resistant Staphylococcus aureus dacryoadenitis. Liu W, Rootman DB, Berry JL, et al. JAMA Ophthalmol. 2014;132(8):993-5.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.