What is Canaliculitis?
Canaliculitis is a disease of the lacrimal canaliculus, which is a small duct in the eyelid.¹ It typically affects patients over 40 years old.¹ Often, there are no identifiable risk factors. However, in some cases, obstruction in the canaliculus by a punctal plug or other foreign object can initiate bacterial growth.¹
Symptoms of canaliculitis include red eyes, watery eyes, swelling and discharge. Most symptoms present in the corner of the eye closest to the nose.² Doctors often misdiagnose canaliculitis because these symptoms are similar to common eye conditions like allergic conjunctivitis, dry eye disease, blepharitis and meibomian gland dysfunction.² One difference is that canaliculitis often results in stone formation in the canals.¹
Key Takeaways
- Canaliculitis is a rare disorder often mistaken for other eye conditions like blepharitis, dry eye disease and conjunctivitis.
- Doctors aren’t sure what causes canaliculitis, but having punctal plugs may be a risk factor.
- Canaliculitis is treatable with warm compress, medication and in some cases, surgery.
Understanding Canaliculitis
Canaliculitis is a rare condition and makes up only about 2-4% of all lacrimal diseases.³ The condition is even rarer in younger populations, with the average age of an individual with canaliculitis around 40 years.
Because it is so uncommon, many patients experience symptoms more severely or for a longer time due to underdiagnosis.²
Diagnosing Canaliculitis
To diagnose canaliculitis, an eye doctor (optometrist or ophthalmologist) will perform a physical assessment of the affected eye. They will express and probe the canaliculus to look for discharge or drainage issues, unless the eye is acutely and severely inflamed, then probing is avoided¹
A doctor can perform laboratory tests from cultures taken during the examination to look for common pathogens that may contribute to canaliculitis development.¹ Additionally, if a patient has punctal plugs or canaliculus obstruction is suspected, a doctor may use imaging to check for potential blockages.²
Treating Canaliculitis
Patients can manage canaliculitis at home with a warm compress and massage. Warm compresses can be made using a soft cloth and warm water, or come available as a self-heating eye mask. Warm compress and massage help loosen and break-up the canalicular obstruction.² Eye doctors can also prescribe topical or oral antibiotics to fight bacteria and irrigation to flush out the discharge.²
If an obstruction is present, canaliculitis recurrence is possible and likely. If present, a doctor may perform surgery to remove the blockage (like a stone or punctal plug).² In some cases, doctors may insert a temporary stent in the canaliculus to prevent scarring.¹ Before surgery, doctors will use a local anesthetic to numb the area, and will provide prescription antibiotics and eye drops to use post-surgery to prevent reinfection.²
Surgery for canaliculitis is often successful and may prohibit the recurrence of the disease.²