The lacrimal glands are small, almond-sized structures responsible for producing the watery component of tears. Located in the upper, outer portion of each eye socket, these glands secrete a continuous fluid that cleans and lubricates the eye surface with every blink. When one of these glands becomes inflamed or enlarged, the condition is known as dacryoadenitis.
Associated Symptoms
The most apparent sign of lacrimal gland swelling is a visible lump or puffiness on the outer part of the upper eyelid. This is often accompanied by localized pain, tenderness, and redness in the affected area. A person might also experience an increase in tearing, a condition called epiphora, or notice a discharge coming from the eye.
In some instances, the swelling can become significant enough to cause a slight drooping of the upper eyelid, a condition known as ptosis. Conversely, if the inflammation obstructs the tear ducts, it can lead to symptoms of dry eye because the tears cannot adequately reach the eye’s surface. Swelling of lymph nodes in front of the ear may also occur.
Potential Causes
Infections are a frequent source of acute lacrimal gland swelling. Viral infections are particularly common, especially in children, and are often linked to systemic viruses like the Epstein-Barr virus (the cause of mononucleosis), mumps, and adenovirus, which can cause rapid inflammation in one or both glands.
Bacterial infections can also cause dacryoadenitis, though they are less common than viral causes. Bacteria such as Staphylococcus aureus and Streptococcus pneumoniae can infect the gland, often leading to a more localized and painful swelling, sometimes with a discharge of pus. These infections may ascend from the conjunctiva, the membrane lining the eye, or result from direct trauma to the area.
Beyond infections, many cases of chronic lacrimal gland swelling are linked to systemic inflammatory and autoimmune disorders. In these conditions, the body’s immune system mistakenly attacks its own tissues, including the lacrimal glands. Sjögren’s syndrome is a primary example, where immune cells target both the tear and salivary glands, leading to persistent dry eyes and mouth. Sarcoidosis, another inflammatory disease, can cause granulomas, or small clusters of inflammatory cells, to form in the glands.
Less frequently, swelling may be due to a physical blockage in the ducts that drain tears from the gland, which causes fluid to back up and inflame the gland. In rare cases, a tumor can develop within the lacrimal gland. These can be benign (non-cancerous) or malignant (cancerous) and present as a painless, gradually enlarging mass.
Diagnosis and When to Seek Medical Attention
Diagnosing the cause of lacrimal gland swelling begins with a physical examination of the eye and surrounding tissues. A healthcare provider will assess the location and extent of the swelling, check for tenderness, and evaluate eye movement and vision.
Further testing may be necessary to identify the underlying cause. Blood tests can reveal signs of a bacterial or viral infection or detect specific antibodies associated with autoimmune diseases like Sjögren’s syndrome.
If a tumor or structural issue is suspected, imaging tests such as a CT scan or MRI are used to create detailed images of the gland and eye orbit. In some cases, a biopsy, where a small tissue sample is removed from the gland for analysis, may be performed to distinguish between inflammation and a tumor.
Seek medical attention if the swelling is accompanied by severe pain, high fever, or any changes in vision, as these can be signs of a serious infection or pressure on the eye. Medical evaluation is also recommended if the swelling worsens rapidly or does not improve after a few days.
Common Treatment Approaches
For cases caused by bacterial infections, a course of oral antibiotics is prescribed to eliminate the pathogens and resolve the inflammation. It is important to complete the full prescription to prevent the infection from returning.
If a virus is the cause, treatment is supportive, as most viral infections resolve on their own within a few weeks. Management includes rest and applying warm compresses to the affected eye to reduce swelling and discomfort. Over-the-counter pain relievers may also be recommended to manage pain.
For swelling driven by non-infectious inflammatory conditions, such as sarcoidosis or autoimmune disorders, the focus shifts to managing the systemic disease. Doctors may prescribe corticosteroids, either as eye drops or oral medication, to reduce inflammation. In cases of chronic autoimmune dacryoadenitis, immunosuppressive medications might be used to control the immune response.
If a tumor is the cause, treatment depends on the findings of a biopsy. Options may include surgical removal of the tumor, radiation therapy, or other targeted cancer therapies.