Dacryocystitis is an inflammation or infection of the lacrimal sac that occurs when the lacrimal drainage system is obstructed and bacteria infects the sac.
The lacrimal sac is part of the system that connects the eyes to the nasal cavity in order to drain tears away from the surface of the eye.
Dacryocystitis causes unilateral tearing, discharge, swelling, redness, and pain in the inner inferior canthus (the area adjacent to the nose). This inflammation may be acute or chronic, and it can be congenital or occur later in life.
What Are The Symptoms of Dacryocystitis?
The chief symptoms of a dacryocystitis infection are watery eye, pain, redness, and swelling in the inner part of the affected eyelid. If an infection is present, pressing on the area over the lacrimal sac may cause discharge to expel from the corner of the eyelid.
There will often be redness and crusting around the eyelids and lashes. If the infection goes untreated for long enough, a more serious infection can develop and can induce a high fever.
If you have the symptoms of a dacryocystitis infection—including a fever—or if you are feeling ill, it is very important that you seek medical attention immediately in order to avoid further complications and life threatening orbital cellulitis infection.
Excessive tear production is a common symptom of dacryocystitis, and in chronic cases it may be the only symptom. If you are frequently troubled by watery eyes, you may have an obstruction in your tear ducts, and you should see your eye doctor for a diagnosis.
What Causes Dacryocystitis?
Any obstruction of the nasolacrimal duct can prevent tears from draining properly. When this happens, the undrained fluid can become a hospitable environment for bacteria (especially Staphylococcus aureus), making the eye vulnerable to infection. In congenital forms the drainage system near the lacrimal sac is obstructed, stenosed (abnormally narrowed), or not fully developed. One form of congenital dacryocystitis can be caused by a dacryocystocele, which is a type of cyst that usually forms during fetal development. These cysts can often be detected with an ultrasound examination.
Diagnosing Dacryocystitis – Your Doctor’s Perspective
If you are experiencing some of the symptoms of dacryocystitis—or even if you have chronically watery eyes and want to find out why—you should make an appointment to see an ophthalmologist as soon as possible.
Your doctor will examine your eyes thoroughly with a microscope, looking closely at your drainage system to determine whether it is obstructed, and to what degree.
Your doctor may flush fluid through the eyelids to see if the drainage system is flowing properly, and may take a sample of any discharge in order to test for the presence of infectious bacteria. The results of this testing will confirm or rule out a diagnosis of dacryocystitis, and will also help to determine the appropriate treatment.
How Is Dacryocystitis Treated Properly?
If the dacryocystitis is acute and was caused by a bacterial infection, the method of treatment is usually oral antibiotics. Other treatment methods include topical antibiotic drops, warm compresses with gentle massage, and over-the-counter pain medications.
If a fever is present or the patient is very ill in addition to the dacryocystitis, hospitalization is required.
Depending on the cause and severity of your condition, your doctor may advise you to consider a surgical procedure known as dacryocystorhinostomy. The purpose of this procedure is to restore tear flow from the lacrimal sac into the nose.
To accomplish this, a hole is created between the lacrimal sac and the bone of the lacrimal fossa in order to open a connection for the tears to drain. Tubes and drains are left in place in order to prevent the gap that has been created from closing. Other surgical options include balloon surgery, which involves opening narrow tear ducts with balloons.
Talking to Your Doctor
Here are some questions you can ask your doctor about dacryocystitis:
• I have always been troubled with watery eyes. Could chronic dacryocystitis or a tear outflow obstruction be the reason for this?
• Ever since my eye injury, I have suffered recurrent eye infections; is it possible my lacrimal sac was damaged?
• Are there any non-surgical treatments that might help me?