| Dacryocystitis | |
|---|---|
| Other names | field = Ophthalmology |
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| A case of dacryocystitis as seen on CT scan | |
| Specialty | Ophthalmology  |
Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac.[1] The term derives from the Greek dákryon (tear),[2] 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 dacryocystocele. It is most commonly caused by Staphylococcus aureus and Streptococcus pneumoniae.[3] The most common complication is corneal ulceration, frequently in association with S. pneumoniae.[3] The mainstays of treatment are oral antibiotics, warm compresses, and relief of nasolacrimal duct obstruction by dacryocystorhinostomy.[3]
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 dacryocystitis.[5] Sometimes, especially in women, stones may develop in the lacrimal gland, causing recurrent bouts of dacryocystitis; this condition is called "acute dacryocystic retention syndrome."[5] Also due to pneumococcus, infection due to surrounding structure such as paranasal sinuses.
About 60 percent of initial attacks of dacryocystitis will recur.[5] Individuals with a poorly functioning immune system (immunocompromised) may develop orbital cellulitis, which may lead to optic neuritis, proptosis, motility abnormalities, or blindness.[5]