Dacryocystitis is an infection of the tear sac that lies between the inner corner of the eyelids and the nose. It usually results from blockage of the duct that carries tears from the tear sac to the nose. The blocked duct harbours bacteria and becomes infected. Dacryocystitis may be acute (sudden onset) or chronic (frequently recurs). It may be related to a malformation of the tear duct, injury, eye infection, or trauma.
This problem is most common in infants because their tear ducts are often underdeveloped and clog easily. Babies often have recurrent episodes of infection; however, in most cases, the problem resolves as the child grows. In adults, the infection may originate from an injury or inflammation of the nasal passages. In many cases, however, the cause is unknown.
Generally affects one eye
Tenderness, redness, and swelling
Red, inflamed bump on the inner corner of the lower lid
During the examination, the eye care practitioner will determine the extent of the blockage. Cultures may be taken of the discharge to identify the type of infection. The eye care practitioner will also determine whether the infection has affected the eye.
The treatment for dacryocystitis is dependent on the person's age, whether the problem is chronic or acute, and the cause of the infection.
Infants are usually treated first by gently massaging the area between the eye and nose to help open the obstruction along with antibiotic drops or ointments for the infection. Surgery may be necessary to clear the obstruction if medical treatment is not effective and the problem persists over several months.
Before surgery, the eye care practitioner may treat the child with antibiotics to make sure the infection is cleared. The operation is performed under general anaesthesia. The tear duct is gently probed to open the passage.
For adults, the eye care practitioner may clear the obstruction by irrigating the tear duct with saline. Surgery is sometimes necessary for adults if irrigation, or antibiotics fail to resolve the infection or if the infection becomes chronic. In these cases, dacryocystorhinostomy (DCR) is performed under general anaesthesia to create a new passage for the tear flow.
Illustrations by Mark Erickson
With acknowledgement to St. Lukes Eye Hospital.