Canaliculitis

Canaliculitis is inflammation of the lacrimal canaliculus. It is an uncommon condition which ophthalmologists frequently misdiagnose. The condition is challenging to eradicate. The condition may be misdiagnosed and treated as conjunctivitis, blepharitis, dacryocystitis, mucocele, and chalazion, thus leading to prolonged morbidity to the patient. In  authors describe it as the "most misdiagnosed disease." Von Graefe was the first person to recognize the cause of canaliculitis as an infectious entity. Canaliculitis can be primary or secondary. Secondary canaliculitis is often seen as a complication of punctal or intercanalicular plug insertion for treatment of dry eye. The canaliculi are an important component of the proximal part of the lacrimal drainage system. They begin at the lacrimal puncta, and in most patients, converge to form the common canaliculus. These canals travel through the eyelids for approximately 8 millimeters. The upper canaliculus is shorter and narrower than the lower, and it has a sharp angulation before merging with the lower canaliculus to form the common canaliculus. The lower canaliculus is almost entirely horizontal.