Canaliculitis

What is canaliculitis?

Canaliculitis is inflammation of the small channels in your eye (canaliculi). Your four canaliculi (two in each eye) help drain tears. Canaliculitis causes your eye to become red and painful with watery discharge, especially on the side nearest your nose.

Who does it affect?

Anyone can get canaliculitis. It’s more common in people assigned female at birth (AFAB) and people over age 40.

How common is canaliculitis?

Canaliculitis isn’t common. About 2% to 4% of conditions affecting the tear system are canaliculitis.

What are the symptoms of canaliculitis?

When one canaliculus or both canaliculi become infected or injured, canaliculitis may develop. Canaliculitis symptoms include:

• Cloudy fluid that drains from your eye (discharge).
• Eye pain.
• Hard, stone-like bumps in your canaliculi.
• Red eye.
• Swollen punctum.
• Watery eyes (epiphora).
• Skin discoloration around your eyelids.

What causes canaliculitis in the eye?

Infection with Actinomyces israelii bacteria typically causes canaliculitis. But canaliculitis symptoms may also develop when canaliculi become infected with:

• Fungi.
• Other bacteria.
• Viruses.

Sometimes, silicone plugs inserted into your punctum to treat dry eyes can become loose. Plugs may travel into your canaliculi and cause inflammation. A plug or other object lodged in your canaliculi may increase your likelihood of developing an infection.

Does canaliculitis affect my vision?

Typically, canaliculitis won’t affect your vision permanently. But the condition causes symptoms like swelling and watery eyes that may temporarily affect how well you see. Talk to your healthcare provider if you develop canaliculitis symptoms.

Can injury cause canaliculitis?

Inflammation can develop after eye injuries when your canaliculi experience trauma. Severe eye injury may result in a cut to your canaliculus, known as canalicular laceration. When this occurs, eye surgeons perform canalicular laceration repair.

Is canaliculitis contagious?

No, canaliculitis isn’t contagious.

How do healthcare providers diagnose canaliculitis?

If you have symptoms, see an eye care specialist called an ophthalmologist. This provider thoroughly examines your eyes. They talk with you about your symptoms and look for redness and upper punctum swelling (known as pouting punctum). Your provider may press on your punctum or near your canaliculi to see if discharge drains from your eye.

What tests do healthcare providers do to diagnose canaliculitis?

Your provider does an exam (clinical evaluation) to check your symptoms. They ask you about your symptoms to make a differential diagnosis — figuring out all the conditions that may cause your symptoms. Other conditions that may cause pain, redness and watery eyes include:

• Blepharitis.
• Pink eye (conjunctivitis).
• Stye.

Your provider may take a sample of eye discharge to examine under a microscope to determine if you have a bacterial infection.

How do healthcare providers treat canaliculitis?

Antibiotics can get rid of the bacterial infection. Your healthcare provider may prescribe oral antibiotics, antibiotic creams or antibiotic eye drops. Providers may also flush (irrigate) your eyes with an antibiotic solution.

Are there at-home treatments for canaliculitis?

Canaliculitis home remedies include putting a warm compress on your eyes. Your provider may recommend you use a warm washcloth to gently heat the area and reduce swelling. They may also recommend you gently massage the area.

Will I need canaliculitis surgery?

If you develop canaliculitis suddenly, known as acute canaliculitis, you may have treatment with antibiotics, compresses and massage. If those treatments don’t work, providers can remove objects lodged in your canaliculi during outpatient surgery called canaliculotomy.

Your provider may insert a tiny tube (stent) during surgery to help tears drain. They may leave the incision open while the area heals, or you may have stitches.

What is recovery like after canaliculitis surgery?

Your incision heals during recovery after canaliculitis surgery. If you have a stent, your provider typically removes it after a few months during an in-office procedure.

Are there complications of canaliculitis?

Canaliculitis can be challenging to diagnose and treat. Without prompt treatment, the condition may last for a long time (chronic canaliculitis), and sometimes, infection may recur (come back). Some people who have canaliculitis surgery experience scarring.

How can I take care of myself if I have canaliculitis?

Call your healthcare provider if you experience red or swollen eyes or if your eyes water a lot. Follow your provider’s instructions for how to manage canaliculitis at home.

How can I reduce my risk of developing canaliculitis?

A bacterial infection is the most common cause of canaliculitis. You can help protect yourself from infection if you:

• Avoid touching your eyes.
• Clean or change your contact lenses regularly.
• Discard eye makeup after a few months (or immediately after having an eye infection).
• Wash your hands.

How do I know if I’m at risk for canaliculitis?

Canaliculitis can happen to anyone. But you may be at higher risk if you’ve had punctal plugs inserted to treat dry eyes. Contact your healthcare provider if you notice any eye symptoms like redness, pain or watering.

What can I expect if I have canaliculitis?

Canaliculitis may take time to resolve. Be sure to take all medications and use creams and eye drops exactly as your provider instructs.

Is canaliculitis curable?

Canaliculitis is curable, but it’s important to seek treatment early for the best health outcome. Contact your healthcare provider if you have symptoms.

When should I see my healthcare provider if I have canaliculitis?

Call your healthcare provider if you notice any new symptoms or if your symptoms get worse.

A note from Cleveland Clinic

Red, painful or watery eyes can be scary and uncomfortable. You may wonder if your symptoms are a sign of something serious. Talk to your healthcare provider. You may have canaliculitis, an inflammation caused by infection or obstruction of the tiny channels that move tears from your eyes to your nose. Your provider may prescribe antibiotics to treat the infection and can recommend at-home treatments to relieve pain and reduce swelling.