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Updated: Jul 31, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Microbial profile of lacrimal system Dacryoliths in American Midwest patient population
Peter M Kally1,2, Amro Omari1, Dianne M Schlachter1,2
1Department of Ophthalmology, Beaumont Eye Institute, Royal Oak, Southfield, Michigan, USA.
Purpose:
Dacryoliths of the canalicular pathway are classically attributed to Actinomyces species as the most common organism. However, global shifts toward Streptococcus and Staphylococcus species have been reported. The objective of this article is to update the American Midwest epidemiology of lacrimal system dacryoliths for targeted clinical treatment.
Materials And Methods:
A retrospective chart review from January 2015 to 2021 of patients with a history of surgical procedure for lacrimal removal of dacryolith for canaliculitis, canalicular obstruction, dacryocystitis, and nasolacrimal duct obstruction was included. Specimens were sent for histopathological evaluation and microbial culture.
Results:
A total of 48 specimens were included. The most common organism isolated for canalicular pathology was Actinomyces spp (23%), followed by Staphylococcus spp (21%) and Streptococcus spp (19%). Histopathological staining accounted for 45% of Actinomyces isolation when culture data inconclusive. In a subgroup analysis of lacrimal sac dacryoliths, the most common organism was Staphylococcus spp (29%). Actinomyces species were not isolated from the lacrimal sac or nasolacrimal duct.
Conclusion:
Actinomyces maintains a microbial predominance in canalicular dacryoliths and requires careful culture and histopathological analysis for its fastidious nature. Lacrimal sac and nasolacrimal duct dacryolith found no isolates of Actinomyces, and the most common organism was Staphylococcus.
Insights
Actinomyces remains the most common cause of canalicular dacryoliths, but Staphylococcus is prevalent in the lacrimal sac. This study updates Midwest epidemiology for better treatment of lacrimal system infections.
Area of Science:
- Ophthalmology
- Microbiology
- Epidemiology
Background:
- Dacryoliths, or calcifications in the tear drainage system, are often linked to Actinomyces species.
- Recent global trends suggest increasing prevalence of Streptococcus and Staphylococcus in dacryoliths.
- Understanding regional microbial patterns is crucial for effective clinical management.
Purpose of the Study:
- To update the epidemiology of lacrimal system dacryoliths in the American Midwest.
- To identify the predominant microorganisms associated with dacryoliths in different anatomical locations of the lacrimal system.
- To inform targeted clinical treatment strategies.
Main Methods:
- Retrospective chart review of patients undergoing surgical dacryolith removal from January 2015 to December 2021.
- Analysis of 48 specimens from cases of canaliculitis, canalicular obstruction, dacryocystitis, and nasolacrimal duct obstruction.
- Specimens underwent histopathological evaluation and microbial culture.
Main Results:
- Actinomyces species were the most frequently isolated organism (23%) from canalicular dacryoliths.
- Staphylococcus species (21%) and Streptococcus species (19%) were also common in canalicular dacryoliths.
- In contrast, Staphylococcus species (29%) predominated in lacrimal sac dacryoliths, with no Actinomyces isolates.
Conclusions:
- Actinomyces remains the primary pathogen in canalicular dacryoliths, necessitating precise diagnostic methods including histopathology.
- Staphylococcus is the leading cause of dacryoliths in the lacrimal sac and nasolacrimal duct.
- These findings highlight anatomical variations in microbial etiology and guide treatment approaches for lacrimal system dacryoliths.
