Primary lacrimal canaliculitis - A clinical entity often misdiagnosed.
Primary lacrimal canaliculitis - A clinical entity often misdiagnosed.
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DOI：
10.1016/j.joco.2017.06.010
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发表时间：
2018-03
影响因子：
1.5
通讯作者：
Kaur M
中科院分区：
文献类型：
--
作者：
Singh M;Gautam N;Agarwal A;Kaur M
原发性泪小管炎（PLC）是一种独特的疾病，经常被一般以及专业培训的眼科医生误诊。有慢性或反复溢泪史的老年患者，常被误认为慢性泪囊炎。我们报告的目的是讨论我们PLC患者的误导性疾病，并重新审视这种隐藏的疾病。对原发性肝癌误诊病例进行分析。描述了患者的临床病史、临床表现、误诊和最终处理。误诊女性5例。慢性红肿、流泪、分泌物和内眦区水肿的病史导致3例（60%）误诊为慢性泪囊炎，2例（40%）误诊为内侧睑板腺囊肿。裂隙灯检查发现局限性充血（n = 5），典型的泪点撅起（n = 3）和可表达的脓性分泌物（n = 3）。2例无泪点撅起的患者泪小管区域明显呈黄色/变色。我们的患者在准确诊断之前平均有4次就诊。3例行三剪泪点成形术及泪小管刮除术，2例行保守治疗。在最后一次随访时，所有患者均无泪点和泪小管瘢痕，其中3例接受了手术。PLC是一种经常被误诊的临床实体，它延迟了适当治疗的开始。泪点及泪小管区的简易放大检查可为准确诊断提供足够的线索。
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. 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. 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. 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.