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Dacryocystitis - Causes, Symptoms & Treatment


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Dacryocystitis is an inflammation of the lacrimal sac at the inner corner of the eye. Dacryocystitis may occur suddenly (acute) or be longstanding (chronic). In acute infection, the area around the lacrimal sac is painful, red, and swollen. The blocked duct harbors bacteria and becomes infected. Dacryocystitis may be acute (sudden onset) or chronic (frequently recurs). It may be related to a malformation of the tear duct, injury, eye infection, or trauma. This problem is most common in infants because their tear ducts are often underdeveloped and clog easily. Babies often have recurrent episodes of infection; however, in most cases, the problem resolves as the child grows. Slight pressure applied to the lacrimal sac may push pus through the opening at the inner corner of the eye, near the nose. The lacrimal bone forms the medial wall superiorly, and the inferior concha of the ethmoid bone forms the medial wall of the canal inferiorly. Tear dicts also can become blocked after trauma to the nose or eyes, such as a broken nose,or by nasal polyps.Chronic dacryocystitis may require treatment to relieve tear duct blockage. Incision and drainage of the abscess may be necessary. This would typically involve a procedure known as dacryocystorhinostomy.

The lacrimal sac is a small chamber into which tears drain. Usually, dacryocystitis results from a blockage of the nasolacrimal duct, which leads from the lacrimal sac into the nose. This condition most commonly presents when there is obstruction in the tear drainage pathways or a stone in the lacrimal sac. This condition is treated with oral or IV antibiotics depending on the severity, sometimes with hospitalization.Incision and drainage of the abscess may be necessary. Dacryocystitis is a congenital condition occurring in up to one third of newborns. For chronic infections, the blocked nasolacrimal duct may be opened with a probe or by surgery. In rare instances, surgical removal of the entire lacrimal sac may be necessary.

Causes of Dacryocystitis

The common Causes of Dacryocystitis :

  • Injury to the nose.
  • Eye infection.
  • Tumor.
  • Nasal inflammation ( see Cold-like symptoms ).
  • Age-related changes affecting the eyes and eyelids in older adults.
  • The most common organisms isolated from the lacrimal sacs of children with dacryocystitis include Staphylococcus aureus, Haemophilus. influenzae, beta-hemolytic streptococci, and pneumococci.
  • Blocked tear duct.
  • Obstruction of the nasolacrimal duct by a tight inferior meatus has been noted in many infants.

Symptoms of Dacryocystitis

Some common Symptoms of Dacryocystitis :

  • Tenderness, redness, and swelling.
  • Discharge.
  • Redness of inner corner of eye
  • Fever.
  • Watery eye.
  • Swelling near inner corner of eye.
  • Generally affects one eye.
  • Pus near inner corner of eye.

Treatment of Dacryocystitis

  • Antibiotic ointments.
  • In some cases, doctor may be removed all or part of the lacrimal sac.
  • Antibiotic eyedrops.
  • Surgery may be necessary to clear the obstruction if medical treatment is not effective and the problem persists over several months.
  • Congenital chronic dacryocystitis may resolve with lacrimal sac massage, warm compresses topical, and/or oral antibiotics.
  • Treatment with warm compresses may aid in resolution of the disease.
  • Occasionally, infracting of the inferior turbinate bone, submucuous resection of the turbinate, and/or lacrimal outflow probing may be successful treatment of dacryocystitis.
  • Tear duct irrigation.
  • Blood cultures and cultures of the lacrimal secretions should be obtained prior to antibiotic therapy.