Journal of Eye Diseases and Disorders

Pig-snout canaliculus: A rare presentation of actinomyces canaliculitis in double puncta

6^th International Conference on Optometry & 10^th International Conference on Eye and Vision

June 12-13, 2025 | Webinar

Priya Kapila, Babita Karothiya, Neetu Agarwal, Sudhir Salhotra

MS Ophthalmology, Mela Mal Sood Rotary Eye Hospital, India

Scientific Tracks Abstracts: J Eye

Abstract:

A 70-year-old female presented with a 6-month history of "whitish gritty discharge" from her left eye. Slit-lamp examination showed swelling and erythema on the medial aspect of the left lower eyelid. Upon eversion of the lid, two puncta were observedâ??a primary punctum with a secondary accessory punctum located 2mm lateral to itâ??both plugged with gritty, whitish secretions. Palpation revealed tenderness and thickening of the lower canaliculus. Based on clinical findings, a provisional diagnosis of chronic canaliculitis caused by Actinomyces spp. was established. Treatment included expressing the granules, dilating both puncta, and irrigating with an antibiotic solution. Microbiological examination confirmed the presence of Actinomyces israelii, with sulfur granules in the discharge. The patient was prescribed neomycin eye drops for the left eye and advised on ocular hygiene, warm compresses, and local massage. One week later, symptoms had resolved, and canaliculi were normal on follow-up. The unusual finding of double puncta with a "pig-snout" appearance, attributed to chronic inflammation, represents a rare presentation of Actinomyces canaliculitis. Double puncta can be associated with complications and a poorer prognosis, making early intervention critical. This case emphasizes the efficacy of conservative management in resolving Actinomyces canaliculitis and highlights the significance of double puncta in clinical outcomes. To our knowledge, this is the first reported case of double puncta associated with actinomycotic canaliculitis.

Biography :

Dr Priya Kapila is an ophthalmologist by profession and works with one of the semi-charitable hospitals in India. She holds an MS degree in Ophthalmology and Fellowship in Comprehensive Ophthalmology. Dr Priya has 3 years of practice as a comprehensive ophthalmologist and cataract surgeon. She has also been involved in various research papers and unusual case reports in India. Grown up in the luscious foothills of Himalayas in India, she is passionate about overall well being of her patients and bringing to light any rare case she comes across in Himachal Pradesh that can enlighten us to treat patients better.