Canaliculitis
Infection of the tear-drainage canals of the eyelid
Quick Facts
- Type: Eye / tear-duct infection
- Location: Canaliculi near the inner eyelid corner
- Common cause: Bacterial infection, sometimes with stones
- Often: Mistaken for conjunctivitis at first
Overview
Canaliculitis is an infection of the canaliculi, the very small canals near the inner corner of each eyelid that carry tears from the surface of the eye toward the nose. When these tiny channels become infected, the area turns red and tender and discharges pus, and tears may overflow because drainage is blocked.
The condition is uncommon and is often mistaken at first for conjunctivitis (pink eye) or a stubborn eye infection, because the symptoms overlap and it tends to affect just one eye. A characteristic feature is that tiny stone-like concretions can form inside the canal, and removing them is usually key to curing the infection. With the right treatment the outlook is good.
Symptoms
Symptoms usually affect one eye and center on the inner corner of the eyelid.
- Redness and swelling at the inner corner of the eyelid
- Tenderness over the area
- Discharge of pus, sometimes when the inner corner is pressed
- Watery, overflowing eyes (tearing)
- A red, irritated eye that does not clear with usual eye-drop treatment
- A small visible bump or pouting opening at the inner lid margin
Because these signs resemble conjunctivitis, canaliculitis is sometimes treated as pink eye for a while before the true cause is recognized.
Causes
Canaliculitis is caused by bacteria growing within the canaliculus. Several organisms can be responsible, and in many cases the infection is associated with small concretions or stones that form inside the canal and harbor the bacteria.
- Bacterial infection within the canal, sometimes long-standing
- Concretions (stone-like deposits) that trap bacteria and keep the infection going
- Blockage or narrowing that allows debris and germs to build up
- Occasionally linked to a punctal plug or other material placed in the tear duct
Risk Factors
- Middle or older age
- A previous tear-duct procedure or a punctal plug
- Narrowing or partial blockage of the tear-drainage system
- Recurrent or poorly healing eye infections in one eye
Diagnosis
Diagnosis is based on examination, often with the help of magnification:
- Eye examination: A clinician inspects the inner eyelid corner for redness, a pouting opening, and discharge when the canal is gently pressed.
- Slit-lamp exam: Magnified viewing helps see the inflamed canal and any concretions.
- Culture: A sample of the discharge can identify the bacteria to guide treatment.
- Imaging: Occasionally used if a deeper or unusual blockage is suspected.
Treatment
The cornerstone of treatment is clearing the infected material from the canal, because antibiotics alone often do not resolve the problem when stones are present.
- Removing the concretions: Expressing or surgically removing the stones and debris from the canal usually leads to rapid improvement.
- Antibiotics: Antibiotic eye drops, ointments, or irrigation help clear the infection, sometimes combined with the procedure.
- Warm compresses: Can ease discomfort and help drainage.
- Minor surgery: If the infection keeps returning, a small procedure to open and clean the canal may be needed.
Most people recover well once the infected contents are cleared, though follow-up is important because recurrence is possible.
Prevention
There is no guaranteed way to prevent canaliculitis, but a few steps lower the risk and help avoid complications. Treating eye infections fully rather than stopping early, keeping any tear-duct plugs or implants monitored by your eye doctor, and seeking care for a persistent one-sided red eye that does not respond to usual treatment all help the condition be caught and cleared before it becomes long-standing.
When to See a Doctor
See an eye doctor if you have ongoing redness, discharge, and tenderness at the inner corner of one eyelid, particularly if it has been treated as conjunctivitis without improving. Seek prompt care if the eyelid becomes very swollen, painful, and warm, if the area around the eye is spreading red, or if you develop fever or vision changes, which may signal a deeper infection.
Frequently Asked Questions
Why is canaliculitis often mistaken for pink eye?
Both cause a red, irritated, watery eye with discharge, usually in one eye. Canaliculitis is centered at the inner corner of the eyelid and does not clear with standard eye-drop treatment, which is often the clue that points to the tear-drainage canal instead.
What are the stones in canaliculitis?
They are small, stone-like concretions that form inside the tear canal and trap bacteria. Removing them is usually the most important part of treatment, because antibiotics alone may not cure the infection while the stones remain.
How is canaliculitis treated?
The infected material and any stones are cleared from the canal, often combined with antibiotic drops, ointment, or irrigation. If it keeps coming back, a minor surgical procedure to open and clean the canal may be needed.
Is canaliculitis serious?
It is usually not dangerous and responds well once the canal is cleared. However, an untreated infection can spread or keep recurring, so persistent inner-corner redness and discharge should be checked by an eye doctor.
References
- American Academy of Ophthalmology. Canaliculitis.
- MedlinePlus, U.S. National Library of Medicine. Tear duct infection.
- Mayo Clinic. Blocked tear duct.
- StatPearls, National Library of Medicine. Canaliculitis.