External Eye and Tear Duct Infections

Author:  Michael John Stewart / Editors:  Michael John Stewart, Jonathan D Whittaker / Reviewer: Louise Burrows / Codes: Published: 18/01/2021


Before commencing this session you should complete the Module Session – Initial Assessment of the Eye


This session will look at the assessment and management of infections affecting the external eye and the lacrimal apparatus

After completing this session you will be able to:

  • Identify the anatomical factors that contribute to the development and spread of infections of the eye lid and peri-orbital structures
  • Describe the pathophysiology and clinical features of dacryoadenitis and dacryocystitis, and institute appropriate treatment
  • Differentiate between a chalazion (meibomian cyst) and acute hordeolum of the eye and formulate management strategies for each condition
  • Differentiate between preseptal and orbital cellulitis and formulate a management strategy for both conditions
  • Recognise the serious complications of orbital infections and institute appropriate treatment and referral


  1. Rutar T, Zwick OM, Cockerham KP et al. Bilateral blindness from orbital cellulitis caused by community-acquired methicillin-resistant Staphylococcus aureus. Am J Ophthalmol 2005;140:740-742. View abstract
  2. Jackson K, Baker SR. Clinical implications of orbital cellulitis. Laryngoscope 1986;96:568-574. View abstract
  3. Blomquist PH. Methicillin-resistant Staphylococcus aureus infections of the eye and orbit (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 2006;104:322-345. View abstract
  4. Boden JH, Ainbinder DJ. Methicillin-resistant ascending facial and orbital cellulitis in an operation Iraqi Freedom troop population. Ophthal Plast Reconstr Surg 2007;23:397-399. View abstract
  5. Hospital Episode Statistics [Internet]. Inpatient data. London: The NHS Information Centre for health and social care; c2010. [Accessed 16th May 2016]
  6. Mills DM, Bodman MG, Meyer DR et al. The microbiologic spectrum of dacryocystitis: a national study of acute versus chronic infection. Ophthal Plast Reconstr Surg 2007;23:302-306. View abstract
  7. McCulley JP. Blepharoconjunctivitis. Int Ophthalmol Clin 1984;24:65-77. View abstract
  8. Jones DB, Steinkuller PG. Strategies for the initial management of acute preseptal and orbital cellulitis. Trans Am Ophthalmol Soc 1988;86:94-112. View abstract
  9. Kass LG, Hornblass A. Sebaceous carcinmoma of the ocular adnexa. Surv Ophthalmol 1989;33:477-490. View abstract
  10. Dellinger RP, Levy MM, Carlet JM et al. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008;36:296-327. View abstract
  11. Bergin DJ, Wright JE. Orbital cellulitis. Br J Ophthalmol 1986;70:174-178. View abstract

Leave a Reply