dacryocystitis


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Related to dacryocystitis: chalazion

Dacryocystitis

 

Definition

Dacryocystitis is an inflammation of the tear sac (lacrimal sac) at the inner corner of the eye.

Description

Tears drain into little openings (puncta) in the inner corners of the eyelids. From there, the tears travel through little tube-like structures (canaliculi) to the lacrimal sac. The nasolacrimal ducts then take the tears from the lacrimal sac to the nose. That's why people need to blow their nose when they cry a lot.
Dacryocystitis is usually caused by a blockage of the nasolacrimal duct, which allows fluid to drain into the nasal passages. When the lacrimal sac does not drain, bacteria can grow in the trapped fluid. This condition is most common in infants and people over 40 years old.

Causes and symptoms

In newborn infants, the nasolacrimal duct may fail to form an opening-a condition called dacryostenosis. The cause of dacryocystitis in adults is usually associated with inflammation and infection in the nasal region. Dacryocystitis can be acute, having a sudden onset, or it can be chronic, with symptoms occurring over the course of weeks or months. Symptoms of acute dacryocystitis can include pain, redness, tearing, and swelling at the inner corner of the eye by the nose. In chronic dacryocystitis, the eye area may be swollen, watery or teary, and, when pressure is applied to the area, there may be a discharge of pus or mucus through the punctum.

Diagnosis

Dacryocystitis usually occurs in only one eye. As mentioned, the symptoms can range from watery eyes, pain, swelling, and redness to a discharge of pus when pressure is applied to the area between the bridge of the nose and the inner eyelids. A sample of the pus may be collected on a swab or in a tube for laboratory analysis. The type of antibiotic and treatment may depend on which bacteria is present. In the acute form, a blood test may reveal an elevated white blood cell (WBC) count; with a chronic infection, the WBC count is usually normal. To identify the exact location of the blockage, an x ray can be taken after a dye is injected into the duct in a procedure called dacryocystography.

Treatment

A warm compress applied to the area can help relieve pain and promote drainage. Topical and oral antibiotics may be prescribed if an infection is present. Intravenous antibiotics may be needed if the infection is severe. In some cases, a tiny tube (cannula) is inserted into the tear duct which is then flushed with a sterile salt water solution (sterile saline). If other treatments fail to clear up the symptoms, surgery (dacryocystorhinostomy) to drain the lacrimal sac into the nasal cavity can be performed. In extreme cases, the lacrimal sac will be removed completely.
In infants, gentle massage of the lacrimal sac four times daily for up to nine months can drain the sac and sometimes clear a blockage. As the infant grows, the duct may open by itself. If the duct does not open, it may need to be dilated with a minor surgical procedure.

Prognosis

Treatment of dacryocystitis with antibiotics is usually successful in clearing the infection that is present. If there is a permanent blockage that prevents drainage, infection may recur and surgery may be required to open the duct. If left untreated, the infected sac can rupture, forming an open, draining sore.

Prevention

There are no specific recommendations for the prevention of dacryocystitis, however, good hygiene may decrease the chances of infection.

Resources

Books

Gorbach, Sherwood L., John G. Bartlett, and Neil R. Blacklow, editors. "Dacryocystitis." In Infectious Diseases. 2nd ed. Philadelphia: W. B. Saunders Co., 1998.

Key terms

Canaliculi — Also known as lacrimal ducts, these tube-like structures carry the tears from the eyes to the lacrimal sac.
Cannula — A narrow tube that can be inserted into a duct.
Dacryocystography — An x ray of the tear duct after injection of a dye that is used to help locate a blockage in the duct.
Dacryocystorhinostomy — A surgical procedure to drain the tear sac into the nasal passage.
Dacryostenosis — Obstruction or narrowing of the nasolacrimal duct. May be present at birth.
Nasoacrimal duct — The tube that carries the tears from the lacrimal sac to the nose.
Punctum — Tiny opening at the inner corners of the upper and lower lids. The area for the beginning of tear drainage.

dacryocystitis

 [dak″re-o-sis-ti´tis]
inflammation of the lacrimal sac.

dac·ry·o·cys·ti·tis

(dak'rē-ō-sis-tī'tis),
Inflammation of the lacrimal sac.
[dacryocyst + G. -itis, inflammation]

dacryocystitis

[dak′rē·ōsistī′tis]
an infection of the lacrimal sac caused by obstruction of the nasolacrimal duct. It can be chronic or acute and is congenital in some cases. It is characterized by tearing and discharge from the eye. In the acute phase the sac becomes inflamed and painful. The disorder is nearly always unilateral and usually occurs in infants. It occurs on the left side more commonly than on the right because of the structure of the lacrimal sac. Systemic administration of antibiotics is usual; local topical treatment is seldom effective; rarely a dacryocystorhinostomy may be required. Compare dacryostenosis.
enlarge picture
Dacryocystitis

dac·ry·o·cys·ti·tis

(dak'rē-ō-sis-tī'tis)
Inflammation of the lacrimal sac.
[dacryocyst + G. -itis, inflammation]

dacryocystitis

Inflammation of the tear sac (lacrimal sac) which lies in the eye socket (ORBIT), between the inner corner of the eye and the nose. Inflammation causes permanent obstruction of tear drainage and a watering eye but this can be corrected by surgery.

dacryocystitis (dāˈ·krō·sis·tīˑ·tis),

n an infection in the lacrimal sac that results from nasolacrimal duct obstruction. Responds to antibiotics; in extreme cases surgery may be required.
Enlarge picture
Dacryocystitis.

dacryocystitis

Inflammation of the lacrimal sac. It is a rare condition, which may occur when there is a blockage of the nasolacrimal drainage system. The acute type gives rise to redness, tenderness and swelling below the lid margin, while in the chronic type there is epiphora and with pressure on the lacrimal sac pus will come out of the punctum. Treatment includes broad-spectrum antibiotics and warm compresses but surgery may be needed in the chronic type. See lacrimal fistula; lacrimal apparatus.

dacryocystitis, dacrocystitis

inflammation of the lacrimal sac.
References in periodicals archive ?
Dacryocystitis is inflammation of lacrimal sac and can occur due to trauma and/or infection, leading to blockage of duct system (Slatter, 2003).
Dacryocystitis present as a swelling near the medial canthus of eye and pressure over the lacrimal sac express purulent secretions from lacrimal punctum.
At the same time, canaliculitis can be mistaken for dacryocystitis or NLDO, as occurred with one of our patients.
Symptoms persist if the condition is not treated and may predispose to chronic or acute dacryocystitis.
dacryocystitis 6 57/M SCC 69 High-risk group 51/M SCC 16 53/M SCC 16 49/M SCC 16 35/F SCC, metastatic to neck LN 16 59/M SCC 16 Negative group 46/M Clinical differential Negative 71/F SCC Negative 58/M Ulcerations Negative 68/F SCC Negative 33/M SCC Negative 47/M SCC Negative Abbreviations: HPV, human papillomavirus; LN, lymph node; NS, nonsmoker; SCC, squamous cell carcinoma.
Less frequent cases of blepharitis, scleritis, endophtalmitis, dacryocystitis, and orbital localizations have also been reported [11,12,15].
Eye infections by Streptococcus pneumoniae include corneal ulcer, dacryocystitis and conjunctivitis in both sporadic and outbreak forms (1,2) More often S.
Orbital cellulitis can arise from paranasal sinusitis; trauma to the eye; a retained foreign body in the orbit; ocular surgery; or contagious spread of infection from adjacent structures, such as dacryocystitis, dental abscesses, or preseptal cellulitis.
We report the case of a woman with a 4-month history of right epiphora and dacryocystitis.
Various studies conducted have shown that surgical success co-relates with factors like patient age, duration of obstruction and presence or absence of previous episodes of dacryocystitis.
Dacryocystitis is an infection of the lacrimal sac that is usually caused by obstruction of the nasolacrimal duct.
A successful outcome was defined as elimination of epiphora, absence of dacryocystitis and positive syringing test result 6 months after the surgery.