{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:47:19Z","timestamp":1776725239461,"version":"3.51.2"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Canaliculitis is often mis- or underdiagnosed, leading to delayed and sometimes inadequate treatment.<\/jats:p>\n                  <jats:p>Patients and Methods Thirteen patients with in total of 17 affected canaliculi were analysed. Collected data included demographic characteristics, the affected canaliculus (upper or lower, right or left), duration of symptoms until the correct diagnosis, and previous misdiagnoses and treatments. The objectives of this study were to determine the diagnostic delay and frequency of misdiagnosis, to identify characteristic clinical features, and to evaluate treatment outcomes following surgical management. Additionally, the presence of Actinomyces species in removed concretions from the canaliculi were histologically assessed.<\/jats:p>\n                  <jats:p>Results The mean age was 61\u2009\u00b1\u200911 years (range 36\u200a\u2013\u200a73 years). The mean duration of symptoms before correct diagnosis was 14\u2009\u00b1\u200913 months (range 1\u200a\u2013\u200a48 months). All 17 affected canaliculi were treated surgically by canaliculotomy. At a mean follow-up of 12\u2009\u00b1\u200910 months (range 2\u200a\u2013\u200a52 months), all canaliculotomies remained patent. Twelve of 13 patients (92%) were completely symptom-free, and no recurrence of canaliculitis occurred. In 15 out of 17 canaliculi, concretions were found intraoperatively. Histological examination identified Actinomyces species in 11 of 15 concretions (73%; 95% confidence interval, Wilson method: 48\u200a\u2013\u200a89%), supporting their leading role as causative organisms of canaliculitis.<\/jats:p>\n                  <jats:p>Conclusion Canaliculitis remains a mis- or underdiagnosed condition despite its characteristic clinical presentation. Increased awareness and recognition of its typical signs are essential to avoid misdiagnosis and unnecessary treatments. Surgical canaliculotomies allow complete removal of bacterial concretions which are found in the canaliculi for the most part. Therefore, timely canaliculotomy should be regarded as the treatment of choice for this often-overlooked condition.<\/jats:p>","DOI":"10.1055\/a-2769-3792","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:33:28Z","timestamp":1771374808000},"page":"271-276","source":"Crossref","is-referenced-by-count":0,"title":["Canaliculitis: Too Often Underdiagnosed?"],"prefix":"10.1055","volume":"243","author":[{"given":"Johanna","family":"Riepl","sequence":"additional","affiliation":[{"name":"Ophthalmology, TAZZ Talacker Augenzentrum, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Kniestedt","sequence":"additional","affiliation":[{"name":"Ophthalmology, TAZZ Talacker Augenzentrum, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Frimmel","sequence":"additional","affiliation":[{"name":"Ophthalmology, TAZZ Talacker Augenzentrum, Zurich, Switzerland"},{"name":"Ophthalmology, University Hospital Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/IOP.0b013e318244a367","article-title":"Punctum-sparing canaliculotomy for the treatment of canaliculitis","volume":"28","author":"J Khu","year":"2012","journal-title":"Ophthal Plast Reconstr Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.sjopt.2015.08.004","article-title":"Primary canaliculitis: the incidence, clinical features, outcome and long-term epiphora after snip-punctoplasty and curettage","volume":"29","author":"U R Kim","year":"2015","journal-title":"Saudi J Ophthalmol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/IOP.0000000000000213","article-title":"Vertical canaliculotomy with retrograde expression of concretions for the treatment of canaliculitis","volume":"31","author":"B Perumal","year":"2015","journal-title":"Ophthal Plast Reconstr Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"338","DOI":"10.4103\/0301-4738.41423","article-title":"Intracanalicular antibiotics may obviate the need for surgical management of chronic suppurative canaliculitis","volume":"56","author":"E R Mohan","year":"2008","journal-title":"Indian J Ophthalmol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1159\/000310528","article-title":"Canaliculitis: difficulties in diagnosis, differential diagnosis and comparison between conservative and surgical treatment","volume":"208","author":"V P Vecsei","year":"1994","journal-title":"Ophthalmologica"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1001\/archopht.1992.01080140056026","article-title":"Through curettage in the treatment of chronic canaliculitis","volume":"110","author":"M A Pavilack","year":"1992","journal-title":"Arch Ophthalmol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1007\/s00417-004-0871-5","article-title":"Actinomyces canaliculitis: diagnosis of a masquerading disease","volume":"242","author":"D Briscoe","year":"2004","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref8","first-page":"589","article-title":"Lacrimal Canaliculitis: A major review","volume":"39","author":"S S Pal","year":"2024","journal-title":"Semin Ophthalmol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/IOP.0b013e31825fb0cd","article-title":"Primary canaliculitis: clinical features, microbiological profile, and management outcome","volume":"28","author":"S Kaliki","year":"2012","journal-title":"Ophthal Plast Reconstr Surg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/IOP.0b013e31824c88a6","article-title":"Bacterial and mucopeptide concretions of the lacrimal drainage system: an analysis of 30 cases","volume":"28","author":"L J Perry","year":"2012","journal-title":"Ophthal Plast Reconstr Surg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1076\/orbi.23.1.19.28985","article-title":"Canaliculitis: the incidence of long-term epiphora following canaliculotomy","volume":"23","author":"S Anand","year":"2004","journal-title":"Orbit"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1016\/j.ophtha.2009.03.032","article-title":"One-snip punctoplasty and canalicular curettage through the punctum: a minimally invasive surgical procedure for primary canaliculitis","volume":"116","author":"M J Lee","year":"2009","journal-title":"Ophthalmology"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1038\/eye.1993.118","article-title":"Canalicular infection caused by Actinomyces","volume":"7","author":"I Hussain","year":"1993","journal-title":"Eye 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