Dacryocystitis

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Dacryocystitis
Classification and external resources
ICD-10 H04.3-H04.4
ICD-9 375.30
DiseasesDB 3432
eMedicine article/1210688
MeSH D003607

Dacryocystitis is an inflammation of the nasolacrimal sac, frequently caused by nasolacrimal duct obstruction or infection. The term derives from the Greek dákryon (tear),[1] 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 dacrocystocele. It is most commonly caused by Staphylococcus aureus and Streptococcus pneumoniae.[2] The most common complication is corneal ulceration, frequently in association with S. pneumoniae.[2] The mainstays of treatment are oral antibiotics, warm compresses, and relief of nasolacrimal duct obstruction by dacryocystorhinostomy.[2]

Pathophysiology[edit]

A variety of causes may lead to dacrocystitis. 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 dacrocystitis.[3] Sometimes, especially in women, stones may develop in the lacrimal gland, causing recurrent bouts of dacrocystitis; this condition is called "acute dacryocystic retention syndrome."[3]

Clinical features[edit]

  • 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

Prognosis and complications[edit]

About 60 percent of initial attacks of dacrocystitis will recur.[3] Individuals with a poorly functioning immune system (immunocompromised) may develop orbital cellulitis, which may lead to optic neuritis, proptosis, motility abnormalities, or blindness.[3]

See also[edit]

References[edit]

  1. ^ "Dacryo- definition". Retrieved 2009-05-18. 
  2. ^ a b c Oill PA, Montgomerie JZ, Cryan WS, Edwards JE (March 1977). "Specialty conference. Infectious disease emergencies. Part V: patients presenting with localized infections". The Western Journal of Medicine 126 (3): 196–208. PMC 1237503. PMID 349885. 
  3. ^ a b c d Yanoff, Myron; Duker, Jay S. (2008). Ophthalmology (3rd ed.). Edinburgh: Mosby. pp. 1482–1485. ISBN 978-0323057516. 

External links[edit]