Chronic dacryoadenitis is more common than its acute counterpart. It progresses slowly as a proliferative inflammation and typically presents bilaterally. Tumors, in contrast, more commonly present unilaterally, which serves as an important distinguishing feature.
Etiology
The condition arises from various causes, with immune responses being a primary factor. Conditions such as idiopathic orbital inflammatory syndrome (inflammatory pseudotumor) and benign lymphoepithelial lesions are commonly involved. Additionally, sarcoidosis and Sjögren's syndrome can affect the lacrimal gland, manifesting as chronic dacryoadenitis.
Clinical Manifestations
A painless mass may be palpable in the superolateral region of the eyelid, occasionally accompanied by mild ptosis. Tearing and proptosis are uncommon.
Treatment
Management focuses on addressing the underlying cause or primary condition. For inflammatory pseudotumor, sarcoidosis, and benign lymphoepithelial lesions, glucocorticoid therapy—either locally or systemically—is commonly employed. Treatment for Sjögren's syndrome may involve immunosuppressive and anti-inflammatory therapies, complemented by the use of artificial tears. Additional systemic medical management may be necessary. In cases where steroid therapy or similar treatments prove ineffective, biopsy or surgical excision may be considered.