Chronic dacryoadenitis misdiagnosed as eyelid edema and allergic conjunctivitis.

OBJECTIVE

To report the case of a 53-year-old woman with a 2-year history of episodic upper eyelid swelling and nonspecific complaints, who was diagnosed as having allergic conjunctivitis.

METHODS

A complete ocular examination, orbital computerized tomographic (CT) scans followed by complete physical and systemic examinations.

RESULTS

The results of physical and systemic examinations were unremarkable for systemic lymphoma and a primary focus of cancer. The results of the ocular examination were normal. CT scans demonstrated well-defined lesions bilaterally with a homogeneous internal structure in the lacrimal gland fossa, which suggested a diagnosis of chronic dacryoadenitis. The differential diagnosis included lymphoma and orbital metastases. The patient refused a biopsy and was started on a tapering dose of 60 mg oral prednisolone daily. The follow-up CT scans 1 month after cessation of 6-week oral corticosteroid treatment showed near complete resolution of the orbital lesions.

CONCLUSIONS

This case demonstrates that orbital inflammation can be misdiagnosed as refractory allergic conjunctivitis.