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Dacryocystitis is infection of the tear (lacrimal) sac usually due to a blockage in the tear (nasolacrimal) duct.
The tear sac is a small chamber into which tears drain. The usual
cause of dacryocystitis is a blockage of the nasolacrimal duct, which
leads from the tear sac into the nose.
Where Tears Come From
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Dacryocystitis may occur suddenly (acute) or be longstanding (chronic).
Symptoms
Often the dacryocystitis infection is mild. Sometimes, the
infection is severe and can cause fever. Sometimes a collection of pus
(abscess) may form, which can rupture through the skin, creating a
passage for drainage.
In acute dacryocystitis, the area around the tear sac is painful,
red, and swollen. The area around the eye may become red and watery and
may ooze pus. Slight pressure applied to the tear sac may push thick
material through the punctum (the opening at the inner corner of the
eyelid near the nose).
Acute Dacryocystitis
Photo courtesy of James Garrity, MD.
Chronic Dacryocystitis
Photo courtesy of James Garrity, MD.
Chronic dacryocystitis causes the skin over the small chamber into which tears drain (tear sac) to bulge. When pressure is applied, the bulge may not be painful, but a puslike or cheeselike material often comes out of the opening at the inner corner of the eyelid near the nose (punctum or tear duct).
People with chronic dacryocystitis often also have chronic conjunctivitis (pink eye).
Diagnosis
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Symptoms and a doctor's examination
A doctor bases the diagnosis of dacryocystitis on the symptoms and examination findings.
Treatment
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For acute dacryocystitis, antibiotics followed by surgery
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For chronic dacryocystitis, surgery
Acute dacryocystitis is usually treated with an antibiotic taken
by mouth. If a fever is present or if the infection is severe,
antibiotics given by vein may be required. Applying warm compresses to
the area several times a day also helps. After the acute infection
resolves, doctors recommend that people have surgery to bypass the
blockage (dacryocystorhinostomy [DCR]) so that infection does not recur.
DCR is also the main treatment for chronic dacryocystitis.
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