Lacrimal Gland Ductal Cyst Infection Presenting as Acute Orbital Cellulitis With Abscess

Abstract

Herein, the authors report a case of lacrimal gland ductal cyst infection presenting as acute orbital cellulitis with an abscess. A 45-year-old man without any history of trauma and a specific medical history presented with progressive painful periorbital swelling in the left eye and diplopia. At the first visit, the patient showed a best-corrected visual acuity of 0.2; erythematous swelling of the upper eyelid; superficial punctate keratitis, severe conjunctival chemosis in the left eye; and pus in the lateral canthal area. The patient had binocular diplopia and left eyeball movement limitation. Orbital computed tomography showed a peripherally enhanced periorbital soft tissue mass along the superotemporal aspect of the left globe, which was suggestive of an abscess. The authors diagnosed the patient with acute orbital cellulitis with an abscess. Intravenous antibiotics and steroids and topical antibiotics and steroids were administered. On the 4th day of the treatment, visual acuity and eyeball movement limitation had improved, and a small opening of the lacrimal gland duct was observed in the left upper conjunctival fornix. Methicillin-resistant Staphylococcus aureus was identified on culture. Finally, the patient was diagnosed with lacrimal gland ductal cyst infection presenting as acute orbital cellulitis. Lacrimal duct cyst infection should be considered as a cause of orbital cellulitis.