Dacryocystitis: This is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac. It causes pain, redness, and swelling over the inner aspect of the lower eyelid and tearing. It is most commonly caused by bacteria. ¹ The mainstays of treatment are oral antibiotics, warm compresses, and relief of nasolacrimal duct obstruction by surgery.

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Nasolacrimal Duct Obstruction: Tears normally drain through small openings in the corners of the upper and lower eyelids called puncta and enter the nose through the nasolacrimal duct. Tear duct obstruction prevents tears from draining through this system normally results to tearing and if prolonged, eye discharge and infection. Treatment of choice is surgery.

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Thyroid-related Orbitopathy: Otherwise known as Grave’s orbitopathy or Thyroid Eye Disease (TED), is an autoimmune inflammatory disorder of the orbit and periorbital tissues, characterized by upper eyelid retraction, lid lag, swelling, redness (erythema), conjunctivitis, and bulging eyes. ³ It occurs in patients with thyroid problems either hyperthyroidism, hypothyroidism or euthyroidism. Mild disease will often resolve and merely requires measures to reduce discomfort and dryness, such as artificial tears and cessation of smoking. Severe cases are treated with steroids and jointly management with an endocrinologist

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Idiopathic Orbital Pseudotumor: Also known as Nonspecific orbital inflammation (NSOI), is the most common cause of painful orbital mass in adults. It can affect the orbital muscles, lacrimal gland, orbital fats and the structures of the eye. It presents with bulging of the eye with or without eye pain, eye redness and tearing. Treatment options range from oral steroids, surgery, chemotherapy, and irradiation.⁴