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Dacryocystitis

Dacryocystitis is an inflammation of the lacrimal sac at the inner corner of the eye. It usually results from blockage of the duct that carries tears from the tear sac to the nose. 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. Slight pressure applied to the lacrimal sac may push pus through the opening at the inner corner of the eye, near the nose. Sometimes, an infection causes fluid to be retained in the lacrimal sac; a large fluid-filled lacrimal sac is called a mucocele. Babies often have recurrent episodes of infection; however, in most cases, the problem resolves as the child grows. In adults, the infection may originate from an injury or inflammation of the nasal passages. In many cases, however, the cause is unknown.

Tears drain into little openings (puncta) in the inner corners of the eyelids. This is the location of the lacrimal sac, which is part of the nasolacrimal duct (tear drainage system). 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. Surgical correction of the underlying abnormality, if present, is usually necessary once the infection has resolved. This would typically involve a procedure known as dacryocystorhinostomy (DCR).

Causes of Dacryocystitis

The common Causes of Dacryocystitis :

  • Dacryocystitis is usually caused by a blockage of the nasolacrimal duct, which allows fluid to drain into the nasal passages.
  • Nasal inflammation.
  • Age-related changes affecting the eyes and eyelids in older adults.
  • In acute dacryocystitis Staphylococcus aureus and, occasionally, beta-hemolytic streptococci are the cause of dacryocystitis.
  • Tumor.
  • Injury to the nose.
  • Obstruction of the nasolacrimal duct by a tight inferior meatus has been noted in many infants

Symptoms of Dacryocystitis

Some Symptoms of Dacryocystitis :

  • Swelling near inner corner of eye
  • Pain at the inner corner of the eye
  • Excessive tearing
  • Pus near inner corner of eye
  • Watery eye
  • Redness of inner corner of eye
  • Fever

Treatment of Dacryocystitis

  • Surgery (dacryocystorhinostomy) to drain the lacrimal sac into the nasal cavity may also be performed.
  • Dacryocystitis may be treated with antibiotic eye drops or ointment and oral or intravenous antibiotics if necessary.
  • Massage over the infected area, coupled with application of warm compresses often provides relief and speeds the healing process.
  • In some cases, doctor may be removed all or part of the lacrimal sac.
  • If chroni,obtain cultures by aspiration .
  • Occasionally, infracting of the inferior turbinate bone, submucuous resection of the turbinate, and/or lacrimal outflow probing may be successful treatment of dacryocystitis.
  • Congenital chronic dacryocystitis may resolve with lacrimal sac massage, warm compresses topical, and/or oral antibiotics.

 


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