Acute dacryoadenitis is inflammation of the lacrimal gland, which typically causes pain, edema, and erythema in the superotemporal portion of the orbit and surrounding tissues. It is more common in children and young adults but can present at any age.

While dacryoadenitis can present in many ways, the timing of onset is helpful in making management decisions. Acute dacryoadenitis presents in hours to days and is typically quite severe and painful. Chronic dacryoadenitis often presents in a more indolent manner over months to years, and the glands may feel less painful and more irregular than in acute settings. Dacryoadenitis can occur unilaterally or bilaterally.

There are many etiologies of dacryoadenitis, but the two broad categories are infectious and inflammatory reactions. Infectious causes, including bacterial, viral, fungal, and parasitic, tend to cause acute dacryoadenitis. Viral is the most common etiology with Epstein-Barr virus (EBV) being the most common source. Other viruses include cytomegalovirus (CMV), herpes simplex (HSV), influenza, and varicella zoster (VZV). Mumps used to be a common cause of bilateral dacryoadenitis, but the incidence has dramatically decreased due to immunizations.

Inflammatory etiologies, typically more common than infectious, include sarcoidosis, polyangiitis with granulomatosis, thyroid disease, Sjögren syndrome, inflammatory bowel disease, and idiopathic orbital inflammation.

Prognosis for acute dacryoadenitis is generally good but ultimately depends on the state of the underlying systemic disease.