Canaliculitis is a relatively rare but significant condition that affects the eye’s tear drainage system. It occurs when the canaliculi, which are small channels responsible for draining tears from the eyes into the nasal cavity, become infected or inflamed. Canaliculitis can lead to discomfort, pain, and, if left untreated, complications that may affect vision and eye health. In this blog, we will explore what canaliculitis is, its causes, symptoms, diagnosis, treatment options, and how to prevent this condition.

What is Canaliculitis?

Canaliculitis is an infection or inflammation of the canaliculi, the small ducts that drain tears from the eyes into the nose. There are two canaliculi in each eyelid: one in the upper lid and one in the lower lid. These ducts are crucial for the proper functioning of the tear drainage system.

When canaliculitis occurs, one or both of the canaliculi become infected, usually due to a bacterial or viral infection. The most common bacteria involved is Actinomyces israelii, a type of bacteria that naturally resides in the mouth and throat but can cause infections when it enters the tear duct system. Fungal infections can also cause canaliculitis, though they are less common.

The condition can be acute (sudden onset) or chronic (long-lasting). If left untreated, canaliculitis can lead to complications such as dacryocystitis (infection of the tear sac), abscess formation, and damage to the surrounding tissues.

Causes of Canaliculitis

Canaliculitis is typically caused by infections that enter the tear duct system. These infections can occur due to several factors:

1. Bacterial Infection (Actinomyces israelii): The most common cause of canaliculitis is the bacterium Actinomyces israelii. These bacteria are commonly found in the mouth and throat but can invade the canaliculi if there is a blockage or trauma to the tear drainage system. The infection can lead to the formation of a pus-like discharge, which is often the first noticeable symptom.
2. Fungal Infections: Fungal infections, while rarer than bacterial infections, can also cause canaliculitis. These infections tend to occur in people with compromised immune systems or those who wear contact lenses for extended periods.
3. Chronic Blockages: Chronic blockages of the tear ducts can make individuals more susceptible to canaliculitis. Blockages may result from inflammation, infection, or scarring that prevents normal tear drainage.
4. Trauma or Injury to the Eye: Any injury to the eye or surrounding areas can provide an entry point for bacteria or fungi to infect the canaliculi. In some cases, even minor trauma can lead to canaliculitis.
5. Poor Hygiene: Poor hygiene or the presence of foreign objects (like contact lenses or makeup) in the eye can increase the risk of infection. If bacteria or fungi enter the tear ducts, they can cause inflammation and infection.
6. Immune System Deficiency: Individuals with weakened immune systems are more prone to infections, including canaliculitis. Conditions such as diabetes, HIV/AIDS, or cancer treatments like chemotherapy may make a person more susceptible to this condition.

Symptoms of Canaliculitis

The symptoms of canaliculitis can vary depending on whether the condition is acute or chronic. Common symptoms of canaliculitis include:

1. Redness and Swelling: One of the most noticeable symptoms is redness and swelling around the affected eye. The eyelid may become inflamed, and the inner corner of the eye may be particularly tender to the touch.
2. Pus Discharge: Canaliculitis often causes a discharge from the tear duct, which may be yellow, green, or white. This pus may drain from the inner corner of the eye and can be seen when pressure is applied to the eyelid.
3. Pain and Tenderness: The affected eye may become painful, particularly in the corner of the eye. The pain may worsen with eye movement or touch.
4. Tearing: Individuals with canaliculitis often experience excessive tearing or watery eyes. This occurs because the infection obstructs the normal tear drainage process.
5. Eye Irritation: Canaliculitis can cause irritation in the eye, leading to sensations of grittiness, itching, or discomfort.
6. Blurred Vision: In some cases, canaliculitis may cause blurry vision due to inflammation or the discharge affecting the clarity of the tear film.
7. Fever: If the infection spreads or becomes severe, the individual may develop a fever, indicating that the infection is worsening.

Treatment of Canaliculitis

The treatment of canaliculitis depends on the severity of the infection and its underlying cause. Treatment options include:

1. Antibiotics: If the infection is bacterial (typically caused by Actinomyces israelii), the doctor will prescribe oral or topical antibiotics. Oral antibiotics, such as penicillin or clindamycin, are commonly used to treat canaliculitis. Topical antibiotic ointments may also be prescribed to treat the infection directly in the eye.
2. Antifungal Treatment: If the infection is fungal in nature, antifungal medications, either topical or oral, will be prescribed. These medications target the fungal organisms and help clear the infection.
3. Warm Compresses: Applying a warm compress to the affected eye can help reduce swelling and promote drainage of the infected area. This treatment can provide relief from symptoms and encourage the pus to drain naturally.
4. Surgical Drainage: In severe cases of canaliculitis or when the infection does not respond to antibiotics, surgical intervention may be necessary. A procedure known as canaliculotomy may be performed to open up the blocked canaliculus and allow for proper drainage. This procedure is typically minimally invasive and can be done under local anesthesia.
5. Dacryocystorhinostomy (DCR): If canaliculitis is recurrent or complicated by a blocked tear duct, the doctor may recommend a DCR. This surgery involves creating a new drainage pathway between the tear sac and the nasal cavity to bypass the blocked tear duct.

Preventing Canaliculitis

While it is not always possible to prevent canaliculitis, the following measures can reduce the risk of developing the condition:

1. Good Hygiene Practices: Ensure proper hygiene by washing the hands regularly and avoiding touching the eyes with unclean hands. Properly clean contact lenses and avoid wearing them for extended periods.
2. Avoiding Trauma: Avoid any trauma to the eye, such as rubbing or scratching, as this can introduce bacteria or fungi into the tear ducts.
3. Regular Eye Check-ups: Regular eye exams can help detect early signs of canaliculitis or other eye conditions. Early diagnosis allows for prompt treatment and prevents complications.
4. Managing Chronic Conditions: If you have a condition that increases the risk of canaliculitis, such as dry eyes or a weakened immune system, work with your doctor to manage the condition and prevent infections.

Conclusion

Canaliculitis, although a rare condition, can cause significant discomfort and disrupt the normal functioning of the tear drainage system. If left untreated, it may lead to more serious complications, such as dacryocystitis or permanent damage to the tear ducts.

If you experience symptoms of canaliculitis, such as redness, swelling, pus discharge, or eye pain, it is essential to seek medical attention promptly with Dr. Saurbhi Khurana. With early diagnosis and appropriate treatment, canaliculitis can be effectively managed, helping to preserve eye health and prevent long-term issues.