Two cases of epidemic keratoconjunctivitis-associated dacryocystitis

ABSTRACT

This report presents two cases of epidemic keratoconjunctivitis (EKC)-associated dacryocystitis. Both patients presented with preseptal edema. Orbital computed tomography (CT) scans were performed out of concern for orbital cellulitis and revealed soft tissue edema involving the preseptal aspect of the eyelids and also the lacrimal sac. Both patients were initially diagnosed with bacterial preseptal cellulitis with dacryocystitis and admitted for treatment with intravenous antibiotics. After no improvement on antibiotics, both patients were noted to have exam findings consistent with viral conjunctivitis, and one patient had a positive conjunctival swab for adenovirus. Both patients were subsequently treated with topical steroids, and symptoms improved. EKC has previously been identified as a cause of acquired nasolacrimal duct obstruction and canalicular stenosis, and acute inflammation of the lacrimal apparatus may explain this link. Dacryocystitis may also be contributory to the copious tearing seen in patients with epidemic keratoconjunctivitis.

KEYWORDS:

• Dacryocystitis
• epidemic keratoconjunctivitis
• epiphora
• secondary acquired nasolacrimal duct obstruction

Disclosure statement

The authors have no conflicts of interest to disclose. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This report was supported in part by an unrestricted grant from Research to Prevent Blindness, Inc. NY, NY to the Department of Ophthalmology and Visual Sciences.