CANALICULITIS - A RECURRENT AND RECALCITRANT DISEASE

A 62-year-old man presented with 2 year history of watering and discharge in left eye. On examination he had pouting left upper lid punctum associated with discharge. He underwent punctual snip with canalicular curettage. Biopsy confirmed Actinomyces infection and was started on topical Crystalline Penicillin but was lost to follow up. He came back after one year with recurrence. Canaliculotomy with curettage of the upper canaliculus was performed, during which typical yellowish cream granules were obtained. Canaliculus was irrigated with Crystalline Penicillin and Betadine. Patient was treated with topical and systemic Penicillin. Repeat curettage was done a week later. On microscopy gram positive filaments resembling Actinomyces were identified and culture grew Hemophilus aphrophilus which was sensitive to Chloramphenicol. He was started on topical Chloramphenicol in addition to Crystalline Penicillin. At 3 months follow up he was asymptomatic with resolution of canaliculitis.