Table 1 Summary of the clinical differences and treatment options for viral, bacterial and inflammatory dacryoadenitis

Onset

Acute

Acute

Chronic

Age

Children-young adults

Adults

Adults

Laterality

Bilateral or unilateral

Unilateral

Bilateral

Clinical picture

Fever plus tender eyelid swelling with eye discharge and conjunctivitis

Fever plus tender swelling with purulent discharge

Non-tender bilateral swelling plus systemic signs and symptoms related to the primary disease

Management

Supportive therapy

Antibiotic therapy with anti-staphylococcal coverage plus drainage in case of abscess formation

Steroids

In refractory cases, consider methotrexate, radiotherapy or rituximab