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Dacryoadenitis is an inflammatory condition of the lacrimal gland, which may be acute or chronic, and either infectious or non-infectious in origin. It is one of the causes of lacrimal gland enlargement seen clinically and radiologically.

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Etiopathogenesis

Infectious

• Acute viral: mumps, Epstein–Barr virus, adenovirus, influenza.
• Acute bacterial: Staphylococcus aureus, Streptococcus pneumoniae (less common).

Non-infectious inflammatory

• Idiopathic orbital inflammation (orbital pseudotumor).
• Autoimmune: sarcoidosis, Sjögren’s syndrome, IgG4-related disease.
• Associated systemic inflammatory diseases: granulomatosis with polyangiitis, thyroid-associated orbitopathy.

Clinical Features

Acute dacryoadenitis:

• Sudden onset, painful swelling in superolateral orbit (S-shaped lid).
• Redness, tenderness, chemosis, tearing.
• May mimic orbital cellulitis if severe.

Chronic dacryoadenitis:

• Painless, firm, slowly progressive lacrimal gland enlargement.
• Often bilateral (autoimmune/systemic causes).

Radiology