Dacryocystitis: What is it?
Symptoms You May Experience:
Examination: What Your Eye Doctor Will Look For:
What You Can Do:
When To Call Your M.D.:
Treatment:
Prognosis: Will I See Better?
Dacryocystitis is an infection of the tear drainage system.
Tears are normally made by the lacrimal gland under the upper eyelid
and drain out through a system of ducts to the lacrimal sac and out
into the nose. If there is a blockage in this drainage system, tears cannot drain out properly, allowing bacteria to grow in the ducts or lacrimal sac and cause dacryocystitis.
Such blockages of the tear drainage system may be due to aging, injury,
sinus disease, inflammatory diseases, or scarring from previous
episodes of dacryocystitis. In severe cases, the infection can spread to the surrounding skin and other areas of the face or orbit.
If you have
a blockage of your tear drainage system, you may notice excessive
watering of your eyes. If infection develops, resulting in
dacryocystitis, you may notice redness, pain, and swelling of the skin
below the inner corner of the eye, toward the nose. The eye
itself may also feel irritated.
The eye
doctor will examine the area where the tear drainage system is located,
just below the inner corner of the eye. He or she will look for
redness and swelling of the skin, as well as touch the area to check
for tenderness and to see if pus comes out of the tear duct.
If you
notice pain, redness, and swelling of the area of skin just below the
inner corner of the eye, apply warm compresses frequently and call your
eye doctor promptly.
If you
develop constant, excessive tearing, see your ophthalmologist, because
blockage of the tear duct system can be treated before infection
develops. Once you notice pain, redness, and swelling of the skin
below the inner corner of the eye, see your eye doctor promptly so
treatment can be started before the infection spreads.
Active
dacryocystitis is treated with antibiotics taken by mouth. Warm
compresses can help the infection resolve faster. If the
infection has already spread to the orbit or other areas of the face,
intravenous antibiotics and hospitalization may be needed. If an
abscess, or pus pocket, forms in the tear drainage system, your
ophthalmologist may need to cut it open so that the infection can drain
out. Once the active infection is controlled, your
ophthalmologist will check for further blockage. If blockage is
present, surgery may be needed to create a drain for the tears so that
dacrycystitis does not reoccur. Called dacryocystorhinostomy, it
is performed in the operating room under general anesthesia.
Most cases
of dacryocystitis resolve well with antibiotic treatment. Because
the infection is caused by a blocked tear drainage system in most
cases, dacryocystitis often reoccurs if the blockage is not
treated. A dacryocystorhinostomy will fix the blockage in over
90% of patients.
Above: Dacryocystitis Tear Duct Infection (Click Larger View-Warning: Graphic).