Dacryocystitis is an

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dis ...

of the

lacrimal sac The lacrimal sac or lachrymal sac is the upper dilated end of the nasolacrimal duct, and is lodged in a deep groove formed by the lacrimal bone and frontal process of the maxilla. It connects the lacrimal canaliculi, which drain tears from the ...

, secondary to obstruction of the

nasolacrimal duct The nasolacrimal duct (also called the tear duct) carries tears from the lacrimal sac of the eye into the nasal cavity. The duct begins in the eye socket between the maxillary and lacrimal bones, from where it passes downwards and backwards. T ...

at the junction of

. The term derives from the

Greek Greek may refer to: Greece Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group. *Greek language, a branch of the Indo-European language family. **Proto-Greek language, the assumed last common ancestor ...

''dákryon'' ( tear), ''cysta'' (sac), and ''-itis'' (

inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...

). It causes pain, redness, and swelling over the inner aspect of the lower

eyelid An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eye ...

and epiphora. When nasolacrimal duct obstruction is secondary to a congenital barrier it is referred to as

dacryocystocele Dacryocystocele (Dacryocystitis) or timo cyst is a benign, bluish-gray mass in the inferomedial canthus that develops within a few days or weeks after birth. The uncommon condition forms as a result as a consequence of narrowing or obstruction of t ...

. It is most commonly caused by '' Staphylococcus aureus'' and ''

Streptococcus pneumoniae ''Streptococcus pneumoniae'', or pneumococcus, is a Gram-positive, spherical bacteria, alpha-hemolytic (under aerobic conditions) or beta-hemolytic (under anaerobic conditions), aerotolerant anaerobic member of the genus Streptococcus. They ar ...

''. The most common complication is

corneal ulcer Corneal ulcer is an inflammatory or, more seriously, infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma. It is a common condition in humans particularly in the tropics and the a ...

ation, frequently in association with ''S. pneumoniae''. The mainstays of treatment are oral antibiotics,

warm compresses A warm compress is a method of applying heat to the body. Heating sources can include warm water, microwaveable pads, wheat packs and electrical or chemical pads. Some unorthodox methods can include warmed potatoes, uncooked rice, and hard-boiled ...

, and relief of nasolacrimal duct obstruction by

dacryocystorhinostomy Dacryocystorhinostomy (DCR) is a surgical procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function. Process Traditional A small incision is made on the side of the nose and some bone ...

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 dacryocystitis. Sometimes, especially in women, stones may develop in the lacrimal gland, causing recurrent bouts of dacryocystitis; this condition is called "acute dacryocystic retention syndrome." Also due to pneumococcus, infection due to surrounding structure such as paranasal sinuses.

Prognosis

About 60 percent of initial attacks of dacryocystitis will recur. Individuals with a poorly functioning immune system (immunocompromised) may develop

orbital cellulitis Orbital cellulitis is inflammation of eye tissues behind the orbital septum. It is most commonly caused by an acute spread of infection into the eye socket from either the adjacent sinuses or through the blood. It may also occur after trauma. W ...

, which may lead to

optic neuritis Optic neuritis describes any condition that causes inflammation of the optic nerve; it may be associated with demyelinating diseases, or infectious or inflammatory processes. It is also known as optic papillitis (when the head of the optic nerv ...

proptosis Exophthalmos (also called exophthalmus, exophthalmia, proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit. Exophthalmos can be either bilateral (as is often seen in Graves' disease) or unilateral (as is often seen i ...

, motility abnormalities, or

blindness Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as correctable eyewear, assistive devices, and medical treatment� ...

References

External links

{{Eye pathology , adnexa Disorders of eyelid, lacrimal system and orbit

Signs and symptoms

Pathophysiology

Prognosis

See also

References

External links