Dacryocystitis

Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac. The term derives from the Greek dákryon (tear),[1] cysta (sac), and -itis (inflammation). It causes pain, redness, and swelling over the inner aspect of the lower eyelid and epiphora. When nasolacrimal duct obstruction is secondary to a congenital barrier it is referred to as dacrocystocele. It is most commonly caused by Staphylococcus aureus and Streptococcus pneumoniae.[2] The most common complication is corneal ulceration, frequently in association with S. pneumoniae.[2] The mainstays of treatment are oral antibiotics, warm compresses, and relief of nasolacrimal duct obstruction by dacryocystorhinostomy.[2]

Dacryocystitis
Other namesfield = Ophthalmology
A case of dacryocystitis as seen on CT scan
SpecialtyOphthalmology 

Signs and symptoms
  • Pain, swelling, redness over the lacrimal sac at medial canthus
  • Tearing, crusting, fever
  • Digital pressure over the lacrimal sac may extrude pus through the punctum
  • In chronic cases, tearing may be the only symptom

Pathophysiology

A variety of causes may lead to dacryocystitis. Most notably, obstruction of the nasolacrimal duct leads to stasis of the nasolacrimal fluid, which predisposes to infection. Staphylococcus aureus is a common bacterial pathogen causing infectious dacrocystitis.[3] Sometimes, especially in women, stones may develop in the lacrimal gland, causing recurrent bouts of dacrocystitis; this condition is called "acute dacryocystic retention syndrome."[3] Also due to pneumococcus, infection due to surrounding structure such as paranasal sinuses.

Prognosis

About 60 percent of initial attacks of dacryocystitis will recur.[3] Individuals with a poorly functioning immune system (immunocompromised) may develop orbital cellulitis, which may lead to optic neuritis, proptosis, motility abnormalities, or blindness.[3]

See also

References
  1. "Dacryo- definition". Retrieved 2009-05-18.
  2. Oill PA; Montgomerie JZ; Cryan WS; Edwards JE (March 1977). "Specialty conference. Infectious disease emergencies. Part V: patients presenting with localized infections". The Western Journal of Medicine. 126 (3): 196–208. PMC 1237503. PMID 349885.
  3. Yanoff, Myron; Duker, Jay S. (2008). Ophthalmology (3rd ed.). Edinburgh: Mosby. pp. 1482–1485. ISBN 978-0323057516.
Classification
External resources
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