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Background: We report surgical treatment of a patient with dacryocystitis and retinal detachment (RD), which are rare ophthalmic involvements of Wegener granulomatosis (WG)., Case: The patient was a 26-year-old man with WG. He was diagnosed as having WG 4 years ago and he has been treated by maintenance doses of predonisolone and cyclophosphamide. Rheumatoid factor and serum antinuclear antibody were negative. Cytoplasmic pattern-antineutrophil cytoplasmic antibody (C-ANCA) and renal function were normal. He was found to have nasolacrimal duct obstruction and lattice degeneration bilaterally, retinal tear with RD in the left eye and tear without RD in the right eye. No sign of vasculitis was found in fluorescein angiography. Bilateral dacryocystorhinostomy was performed without any sign of postoperative necrosis of the wound. After the surgery, epiphora and eye discharge disappeared and lacrimal passage has been maintained without obstruction. The pathological findings of his nasal mucosa and lacrimal sac showed chronic inflammation and no typical changes of WG. There was no abnormal change in the conjunctiva and sclera after an uncomplicated scleral buckling surgery., Conclusion: We conclude that operations such as dacryocystorhinostomy and scleral buckling surgery may be performed successfully when WG is controlled within the normal limits of C-ANCA.

Background: We report a case of canaliculitis caused by Actinomyces odontolyticus in a case of dry eye with punctal plugs., Case: A 64-year-old female with Sjögren's syndrome type of dry eye developed lacrimation, congestion in the lower palpebral conjunctiva and corneal epithelial damage in her right eye 30 months after punctal plug occlusion. After removal of the plug from lower punctum in her right eye, white material exuded from the punctum. However, even after the removal of a plug, corneal epithelial keratopathy did not get worse, implying that the granulation tissue formed by the plug completely occluded the canaliculus. Actinomices odontolyticus was cultured from the white material. One week after topical antibiotic treatment, conjunctival congestion and irritation were resolved., Conclusion: This report indicates the possibility of canaliculitis as a complication of punctal plug occlusion. Careful observation is necessary after punctal occlusion with punctal plugs.

A seven-year-old case with chronic dacryocystitis resulting from congenital obstruction of the nasolacrimal duct was cured not by a dacryocystorhinostomy but by probing of the duct. Our results show that even in case of planned dacryocystorhinostomy, probing of the duct should be performed at least once.