Dacryocystitis

Dacryocystitis is an infection of the tear sac. The tear sac lies between the inner corner of the eyelids and the nose. The glands of the eyelids always 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 tear sac (lacrimal sac) into the nose. The tears are then swallowed.

If the tear ducts become blocked, bacteria begin to buildup. The tear sac 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, babies may have episodes of tearing and infection. However, in most cases, the problem gets better as the child grows.

CAUSES

  • Malformation of the tear duct.

  • Injury.

  • Eye infection.

  • Trauma.

  • Injury or inflammation of the nasal passages.

The cause is often unknown.

SYMPTOMS

  • Usually only 1 eye is involved.

  • Tearing and discharge 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 by:

  • An exam of the eye to find out how much blockage is present and if the surface of the eye is also infected.

  • Getting cultures to see if a specific infection is present.

TREATMENT

Treatment depends on:

  • The person's age.

  • Whether or not the infection is chronic or acute.

  • Amount of blockage is present.

Additional treatment

  • In infants, 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 eye drops or ointments.

  • If the above 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 tear sac and the inside of the nose (dacryocystorhinostomy or DCR).

HOME CARE INSTRUCTIONS

  • Antibiotic drops or ointment may be prescribed after probing procedures.

  • If surgery has been performed, oral antibiotics may also be prescribed.

  • Finish all medications as prescribed, even if your symptoms get better.

SEEK MEDICAL CARE IF:

You develop tearing of 1 or both eyes and a sore, red, swollen lump between your lower eyelid and nose. This is especially true if you have these symptoms and a fever.

SEEK IMMEDIATE MEDICAL CARE IF:

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

  • There are signs of generalized infection including muscle aches, chills, fever or a general ill feeling.

  • You or your child has an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • Your baby is older than 3 months with a rectal temperature of 102° F (38.9° C) or higher.

  • Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

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