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Purpose: To describe a case of lacrimal gland abscess., Methods: Case report., Results: An 11-year-old boy with respiratory tract infection presented acutely with an enlarging, painful mass in the superotemporal fornix in his left eye. Clinical evaluation and computerized tomography scan of the orbit revealed a lacrimal gland abscess. Conjunctival swab and sputum grew Klebsiella pneumoniae. The child was treated with intravenous amikacin., Conclusions: Lacrimal gland abscess is a rare clinical entity. To our knowledge, this is the first reported case of Klebsiella pneumoniae-associated dacryoadenitis complicated by lacrimal gland abscess formation in a pediatric patient.

Purpose: To assess the effect of mitomycin C on surgical success rate of dacryocystorhinostomy and silicone intubation in patients with improper flaps., Methods: The study was a randomized clinical trial. The patients with indication for dacryocystorhinostomy surgery with silicone intubation (inappropriate lacrimal sac or nasal mucosal flaps during surgery and/or history of dacryocystitis in the past 3 months) were randomly assigned to application of mitomycin C (0.02%) on surgical flaps (group A) or a control group without mitomycin C application (group B). Main outcome measures were subjective symptomatic improvement and result of irrigation test at last follow-up visit., Results: The study enrolled 88 patients (88 eyes); there were 42 patients in group A and 46 patients in group B. There was an average follow-up of 10 months (range 6-15 months) following surgery. Significant improvement (no tearing with patent lacrimal system in irrigation) was observed in 31 patients (73.8%) in group A and 32 patients (69.6%) in group B. There was no statistically significant difference in no improvement (no change in tearing state and obstruction in irrigation test), relative improvement (decreased tearing and passage of fluid with force in irrigation test), and significant improvement rate between the 2 groups of study (p>0.05)., Conclusions: Application of mitomycin C on surgical flaps during dacryocystorhinostomy surgery with silicone intubation in patients with improper flaps has no proven beneficial effect on success rate of surgery.

Purpose: To report a case of dacryocystitis that progressed to orbital abscess resulting in the rare complication of central retinal artery occlusion., Methods: A patient without any other known health problems presented with dacryocystitis complicated by orbital cellulitis, orbital abscess, and finally central retinal artery occlusion despite medical treatment., Results: After 48 hours of medical treatment, there was no recovery, and there was loss of light perception; because of this, surgery indication was determined. Fundus fluorescein angiogram demonstrated findings of central retinal artery occlusion. There was no recovery of light perception after surgical intervention., Conclusions: We report a case of orbital abscess following dacryocystitis in a healthy middle-aged woman resulting in the rare complication of central retinal artery occlusion. To our knowledge, this is the first report of central retinal artery occlusion secondary to orbital abscess following dacryocystitis.

Purpose: To report the ocular manifestations associated with brucellosis in an endemic area., Methods: We prospectively evaluated 147 patients with the diagnosis of brucellosis between May 1996 to May 2000 and recorded the ocular and systemic findings. The diagnosis was based on clinical findings, positive serological and bacteriological tests (Brucella agglutination test: over 1/160 titer, blood culture)., Results: Thirty-eight patients (26.0%) with brucellosis had ocular complications: conjunctivitis in 26 (17.7%), anterior uveitis in six (4.1%), posterior uveitis in one (0.7%), dacryoadenitis in two (1.4%), episcleritis in three (2.1%). Three of the seven patients with uveitis had spondylitis associated with brucellosis. Osteoarticular complications in brucellosis were more frequent in the patients with ocular involvement though the difference was not statistically significant compared with patients without ocular involvement., Conclusions: Ocular manifestations are frequent in brucellosis so an ophthalmologic examination should be routinely performed in patients with brucellosis in endemic areas.

Purpose: To report a case presenting with dacryoadenitis as the earliest manifestation of systemic Wegener's granulomatosis (WG)., Design: Observational case report., Methods: A 41-year-old woman initially presented symptoms of bilateral dacryoadenitis. She subsequently developed upper and lower respiratory tract involvement, scleritis and keratitis., Results: Cytoplasmic antineutrophil antibody (c-ANCA) titer was positive. The lacrimal gland and lung biopsies were consistent with WG. The patient responded well to cyclophosphamide and prednisolone., Conclusions: Dacryoadenitis maybe the earliestpresenting manifestation of WG andprompt immunosuppressive chemotherapy may control it preventing the limited disease from progressing to a complete form and reducing its morbidity and mortality.

Purpose: To present a case of brucellosis-related unilateral dacryoadenitis., Methods: A 16-year-old boy had unilateral lacrimal gland enlargement, shown by magnetic resonance imaging of the orbits. Clinical findings, tube agglutination, the culture of a lacrimal gland aspirate, and histopathological examination confirmed the diagnosis of brucellosis., Results: Tube agglutination testing for brucellosis gave a titer of over 1/640. The aspirate from the lacrimal glands grew Brucella melitensis and histopathological findings were consistent with brucellosis., Conclusions: Dacryoadenitis may occur in the course of systemic brucellosis caused by Brucella melitensis.