Dacryocystitis

ExitCare ImageDacryocystitis is an infection of the tear sac (lacrimal sac). The lacrimal sac lies between the inner corner of the eyelids and the nose. The glands of the eyelids produce tears. This is to keep the surface of the eye wet and protect it. These tears drain from the surface of the eyes through a duct in each lid (lacrimal ducts), then through the lacrimal sac into the nose. The tears are then swallowed.

If the lacrimal sacs become blocked, bacteria begin to buildup. The lacrimal sacs can become infected. Dacryocystitis may be sudden (acute) or long-lasting (chronic). This problem is most common in infants because the tear ducts are not fully developed and clog easily. In that case, infants may have episodes of tearing and infection. However, in most cases, the problem gets better as the infant grows.

CAUSES

The cause is often unknown. Known causes can include:

  • Malformation of the lacrimal sac.

  • Injury to the eye.

  • Eye infection.

  • Injury or inflammation of the nasal passages.

SYMPTOMS

  • Usually only one eye is involved.

  • Excessive tearing and watering from the involved eye.

  • Tenderness, redness, and swelling of the lower lid near the nose.

  • A sore, red, inflamed bump on the inner corner of the lower lid.

DIAGNOSIS

A diagnosis is made after an eye exam to see how much blockage is present and if the surface of the eye is also infected. A culture of the fluid from the lacrimal sac may be examined to find if a specific infection is present.

TREATMENT

Treatment depends on:

  • The person's age.

  • Whether or not the infection is chronic or acute.

  • The amount of blockage is present.

Additional treatment

Sometimes massaging the area (starting from the inside of the eye and gently massaging down toward the nose) will improve the condition, combined with antibiotic eyedrops or ointments. If massaging the area does not work, it may be necessary to probe the ducts and open up the drainage system. While this is easily done in the office in adults, probing usually has to be done under general anesthesia in infants.

If the blockage cannot be cleared by probing, surgery may be needed under general anesthesia to create a direct opening for tears to flow between the lacrimal sac and the inside of the nose (dacryocystorhinostomy, DCR).

HOME CARE INSTRUCTIONS

  • Use any antibiotic eyedrops, ointment, or pills as directed by the caregiver. Finish all medicines even if the symptoms start to get better.

  • Massage the lacrimal sac as directed by the caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • There is increased pain, swelling, redness, or drainage from the eye.

  • Muscle aches, chills, or a general sick feeling develop.

  • A fever or persistent symptoms develop for more than 2–3 days.

  • The fever and symptoms suddenly get worse.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.