The actual lacrimal gland is a kind of lacrimal disease, divided into two kinds of acute lacrimal gland inflammation and chronic lacrimal gland inflammation, the performance is different, the treatment also has the difference. I. Acute lacrimal glanditis The eyelids on the lateral side of the superior orbital rim are red, swollen and painful – be on the alert for acute lacrimal glanditis Twenty-something Wang’s upper right eyelid suddenly became red and swollen in the past few days, and there was pain. The actual fact is that the actual orbital cellulitis is a very good thing. So, what is acute lacrimalitis? Acute lacrimal gland infection is a relatively rare eye disease. There are two general causes, one is primary, that is, the lacrimal gland itself is infected, the pathogen from the lacrimal gland opening upstream infection caused by the lacrimal gland opening in the outer surface of the upper eyelid, the surface of the eye pathogens in the body resistance to weakness may take advantage of the entry. There is another kind of secondary, due to inflammation of the tissues around the lacrimal gland, caused by the spread of inflammation, or various acute infectious diseases secondary to inflammation of the lacrimal gland, such as mumps, influenza, typhoid, pneumonia, acute pharyngitis, etc. The common pathogens that cause acute lacrimal gland inflammation are: staphylococcus, streptococcus pneumoniae, etc. There are also a few cases caused by viruses. The onset of the disease is often characterized by redness, swelling and pain of the eyelids on the lateral side of the superior orbital rim, sometimes the eyelids cannot be lifted, if the upper eyelids are lifted and the eyeballs are turned downward, you can see the inflated part of the lacrimal gland outside the upper part of the eyeballs, in severe cases the enlarged lacrimal gland can compress the eyeballs and displace them in the downward direction. Painful pea-sized masses can be felt under the skin in front of the ear, which are enlarged lymph nodes. Sometimes there is general malaise and an increase in body temperature. The diagnosis can be determined by the acute course of the disease and also by the typical clinical manifestations. Acute dacryoadenitis is sometimes easily confused with orbital cellulitis and mydriasis. The difference is that orbital cellulitis is more diffuse with painful redness and swelling of the eyelids, more pronounced redness and tearing of the eyes, sometimes causing loss of vision, and more severe systemic symptoms. Most of the wheals can be palpated as a distinct subcutaneous hard nodule with a more superficial lesion, whereas acute lacrimal glanditis has no such manifestation. Does the treatment of acute lacrimal glanditis require surgery? If acute lacrimal gland infection develops naturally, a purulent discharge will usually appear in the eye after 2 to 3 weeks, and the inflammation will gradually subside after the pus is drained. In some patients, it may break out from the skin surface and pus flows out from the skin, forming a temporary fistula. However, it is also possible for the inflammation to decrease but not subside, turning into subacute lacrimal glanditis or chronic lacrimal glanditis. In order to avoid prolonged illness, early onset of the disease should be actively treated, generally systemic antibiotics, oral or infusion therapy, local heat, antibiotic eye drops, some patients will gradually ease. However, if the tear gland is observed to be purulent, it is necessary to make an incision and drainage, which can avoid the irregularity of the wound and the difficulty of healing after breaking down by itself, and can also shorten the course of the disease. Since the lacrimal gland is divided into orbital lacrimal gland (deep in the upper orbital rim) and lid lacrimal gland (on the outer side of the upper eyelid), the site of incision and drainage is also different, while the orbital lacrimal gland is incised from the skin surface when it becomes septic, the lid lacrimal gland can be incised from the inner surface of the upper eyelid (conjunctival surface). Before and after treatment of acute lacrimal gland infection in the left eye Chronic lacrimal gland infection Lumps on the lateral eyelids at the superior orbital rim: chronic lacrimal gland infection or chalazion? The upper eyelids of both eyes of Ms. Wang, who is in her forties, have been slowly enlarging for more than ten years, from swollen eyeballs to “goldfish eyes”, because they have been swollen for more than ten years, she did not care much about it, but it is still slowly getting worse in the past two years. The doctor suspected that it was chronic lacrimal gland infection and suggested that she undergo surgery on her left eye, where the enlarged lacrimal gland is obvious, and medication on her right eye, where the enlarged lacrimal gland is not obvious. After the surgical removal and pathological examination, it was confirmed that it was chronic lacrimal glanditis, so her heart finally dropped and her goldfish eye was cured. Chronic dacryoadenitis is more common than acute dacryoadenitis. Some chronic lacrimal gland infections are transformed from acute lacrimal gland infections, but most are caused by systemic or local diseases involving the lacrimal gland, such as tuberculosis and trachoma. The clinical manifestations are not very typical, most of the time both eyes develop, and a lump can be felt on the lateral eyelid at the superior orbital rim, usually painless, which can be moved painfully when pressed, and when carefully touched, the lump can sometimes be felt as lobulated and may be accompanied by ptosis. In chronic lacrimal glanditis of the lid, when the upper eyelid is lifted and the eye is allowed to turn down, the enlarged lacrimal gland can be seen above the outer part of the eye. In orbital chronic lacrimal glanditis, the enlarged tear glands often push the eyeball down toward the nose, limiting eye movement and sometimes causing double vision. Chronic lacrimal glanditis is sometimes difficult to diagnose and requires removal and pathological examination to determine. Clinically, chronic lacrimal glanditis is sometimes difficult to differentiate from another common condition, chalazion. A chalazion is usually located more inferiorly, near the lower edge of the upper eyelid, and a swelling can be palpated that is also painless, but this is smaller in size and harder in texture and needs to be differentiated. Is there a good way to treat chronic lacrimal gland infection? Chronic lacrimal gland infection is usually slow to progress, but it is more cosmetically disruptive and can cause limited eye movement and double vision, and should still be treated. If the cause can be found, such as tuberculosis, trachoma, otitis media, dental caries, etc., it is better to treat the cause. However, most of the time it is difficult to find the cause and often no clear cause can be found, then broad-spectrum antibiotic treatment should be given, and at the same time local injection of hormones in the lacrimal gland can often have a significant effect, many patients after the injection treatment, the enlarged lacrimal gland shrinks significantly and the appearance returns to normal. For patients who do not respond to medication and wish to improve their appearance, a lacrimal gland resection can be performed to remove part of the enlarged lacrimal gland. In recent years, Chinese herbal medicine has been effective in treating chronic lacrimal gland inflammation and has become an option for treating chronic lacrimal gland inflammation.