Journal List > J Korean Ophthalmol Soc > v.55(9) > 1009787

J Korean Ophthalmol Soc. 2014 Sep;55(9):1372-1375. Korean.
Published online September 16, 2014.
©2014 The Korean Ophthalmological Society
A Case of Epstein-Barr Virus-Related Dacryoadenitis
Sang Myung Kim, MD and Jin Sook Yoon, MD, PhD
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to Jin Sook Yoon, MD, PhD. Department of Ophthalmology, Severance Hospital, #50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-3570, Fax: 82-2-312-0541, Email:
Received January 17, 2014; Revised March 12, 2014; Accepted July 17, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



To report a case of Epstein-Barr virus-related dacryoadenitis.

Case summary

A 19-year-old female presented with pain, swelling and redness of both upper eyelids. She experienced rhinorrhea, cough and fever for the previous two weeks. Physical exam showed bilateral cervical lymph node enlargement, and orbital computed tomography (CT) revealed diffuse enlargement and inflammation of both lacrimal glands. Serological testing revealed elevated titers for Epstein-Barr virus nuclear antigen immunoglobulin G (IgG) and Epstein-Barr viral capsid antigens IgG and immunoglobulin M (IgM). Based on these results, clinical diagnosis of Epstein-Barr virus-related acute dacryoadenitis was made. The inflammation subsided after conservative management. Relapse was not observed during the three-month follow-up period.


Based on acute bilateral lacrimal gland enlargement, systemic symptoms such as fever, rhinorrhea, cough, lymphadenopathy and serologically-positive results for Epstein-Barr virus, Epstein-Barr virus-related acute dacryoadenitis can be clinically diagnosed and treated with conservative therapy.

Keywords: Acute dacryoadenitis; Epstein-Barr virus; Painful eyelid swelling


Figure 1
(A) Erythematous swelling of both the upper eyelids at the first visit. (B) No relapse of dacryoadenitis at 3 months after conservative therapy.
Click for larger image

Figure 2
(A) Orbital computed tomogram without enhancement shows both lacrimal glands enlargement. (B) Axial view shows preseptal soft tissue swelling.
Click for larger image


This study was presented as a poster at the 111th Annual Meeting of the Korean Ophthalmological Society 2014.

1. Rhem MN, Wilhelmus KR, Jones DB. Epstein-Barr virus dacryoadenitis. Am J Ophthalmol 2000;129:372–375.
2. Wilhelmus KR. Mumps. In: Gold DH, Weingeist TA, editors. The eye in systemic disease. Philadelphia: JB Lippincott; 1990. pp. 262-264.
3. Fitzsimmons TD, Wilson SE, Kennedy RH. Infectious dacryoadenitis. In: Pepose JS, Holland GN, Wilhelmus KR, editors. Ocular infection and immunity. St. Louis: CV Mosby; 1996. pp. 1341-1345.
4. Massaro BM, Tabbara KF. Infections of the lacrimal apparatus. In: Tabbara KF, Hyndiuk RA, editors. Infections of the eye. Boston: Little Brown & Co; 1996. pp. 551-558.
5. Herken H. Beitrag zur pathologischen Histologie der Tränendrüse. Arch Augenheilkd 1936;110:61–75.
6. Niederman JC, McCollum RW, Henle G, Henle W. Infectious mononucleosis. Clinical manifestations in relation to EB virus antibodies. JAMA 1968;203:205–209.
7. Yuen SJ, Rubin PA. Idiopathic orbital inflammation: distribution, clinical features, and treatment outcome. Arch Ophthalmol 2003;121:491–499.
8. Rai P, Shah SA, Kirshan H. Acute Dacryadenitis-analysis of 23 cases. Med Channel 2009;15:71–76.
9. Belanger C, Zhang KS, Reddy AK, et al. Inflammatory disorders of the orbit in childhood: a case series. Am J Ophthalmol 2010;150:460–463.