Dacryocystitis

The lacrimal sac is a small structure in the eye into which tears drain. When this becomes inflamed, the condition is referred to as dacrocystitis. The inflammation can be acute or chronic. In the acute type, the involved area may appear red and swollen with accompanying pain. Usually the condition is mild. However, it can be severe which may cause fever to the affected person. Some authors suggest a third type called congenital dacrocystitis which is a serious and possibly fatal disease as newborns can develop brain abscess, sepsis or meningitis.  ^{[1] [2] [3]}

Epidemiology

African Americans rarely develop the condition owing to some anatomical differences as compared to caucasians. More adult females are affected. The congenital type equally affects both genders. The acquired type predominantly affects women with age greater than 40 years old. ^[3]

Causes

The typical cause is an obstructed tear duct. This often precipitates to bacterial growth. ^[1] Risk factors include anatomical defects like narrowed ducts, nasal polyps, eye wounds or injuries and local infections. ^[4]

Signs and Symptoms

In the acute condition, patients experience sudden onset pain, redness and swelling over the involved region. Some may have fever and increased white blood cell count as revealed by a blood test.

The chronic type is usually manifested by tearing. Some patients may complain of decreased visual acuity

In pediatric patients, there can be fever, pus in the eye corner and crusting after sleep. Reddening and tenderness near the eye corner may be noted as well. ^[4]

Diagnosis

After getting the patient’s medical history, a physical examination is performed which consists of a thorough eye examination. Fluid samples from the eye may be taken to be cultured. Imaging studies may be requested if mass lesions and trauma are suspected causes. ^{[3] [4]}

Complications

The inflammation may extend to the orbital area and form orbital cellulitis. This may lead to blindness. Some may even develop cavernous sinus thrombosis which could be fatal

Treatment

Antibiotics are often prescribed for bacterial infection. Applying warm compress to the area may help. A surgical procedure called dacryocystorhinostomy may be recommended especially for chronic cases. ^[2]

References:

1.      http://www.thirdage.com/hc/c/dacryocystitis

2.      http://www.merckmanuals.com/home/eye_disorders/eyelid_and_tearing_disorders/dacryocystitis.html

3.      http://emedicine.medscape.com/article/1210688-overview#a0199

4.      http://pediatrics.med.nyu.edu/conditions-we-treat/conditions/dacryocystitis