Dacryocystitis
Dacryocystitis is an infection of the nasolacrimal sac or tear drainage passage. Lacrimal sac connects the lacrimal punctum through lacrimal duct to the nose. It is responsible for drainage of tears from the eye to the nose. Many causes can lead to obstruction of nasolacrimal duct.
Types of Dacryocystitis
1- Acute Type
There is acute infection of the lacrimal sac. The most common microorganisms are Staphylococcus aureus and Streptococcus pneumonia.
2- Chronic Type
This can be caused by Streptococcus pneumonia. fungus such as Actinomyces Israelii and Candida Albicans can also cause it.
Causes
1- Infants and children
Congenital atresia, stenosis. Atresia means complete closure of the duct while stenosis means the duct is opened but the orifice is too narrow which can be blocked easily.
2- Adults
Obstruction from old infection, trauma to nose or orbit and tumors.
Dacryocystitis symptoms and signs
1- Acute Dacryocystitis
Pain. It can be very painful.
Swelling, redness and tenderness in the inner corner of the eye or medial canthus.
Excessive lacrimation or tearing because the drainage is blocked.
Pus can be extruded from the inner corner through the punctum when digital pressure applied.
Fever.
2- Chronic Dacryocystitis
There are no acute symptoms but excessive lacrimation can occur. Sometimes, painless swelling can be felt in the inner corner of the eye.
Diagnosis
1- History, signs and symptoms and clinical examination.
2- Pus and discharge culture.
3- Dacryocystography. It is a special type of X-ray imaging with dye injection into the duct. This test can be helpful to locate the site of obstruction.
Dacryocystitis Treatment
1- Topical and systemic antibiotics.
2- Drainage of the pus.
3- Treatment of the cause.
4- Dacryocystorhinostomy or DCR. It is a surgical procedure which will help to relieve the obstruction of nasolacrimal sac or duct.
