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Eye Matters
November 18, 2005

What is Dacryocystitis

In order to best understand this disease it is necessary that we identify what is the tear or lagrimal system.

This consists of a secretory part (lagrimal gland) and an excretory part comprising of the lagrimal punctas (openings), lagrimal sac and nasolagrimal duct (tear duct).

We can now define dacryocystitis as an infection of the tear sac which usually results from blockage of the duct that carries the tears from the tear sac to the nose. It is generally unilateral (affects one eye) and may result from a malformation of the tear duct, injury, eye infection or trauma.{{more}}

This problem is most common in infants because their tear ducts are often underdeveloped and clog easily. Babies often have recurrent episodes of infection, but more than 95% resolve spontaneously during the first year.

Meanwhile in adults the infection may originate from an injury or inflammation of the nasal passages; in many cases however the cause is unknown.

In our physical examination we can find epiphora (excessive tearing), redness or swelling, purulent secretions on squeezing the lagrimal sac and an inflamed, painful bump on the inner corner of the lower lid.

During the examination, the ophthalmologist will determine the extent of the blockage. Cultures may be taken of the secretions to identify the type of infection and the physician will determine whether the infection has affected the eye. The most common germs are staphylococci and streptococci.

How is this disease treated? This depends on the person’s age, whether the problem is acute or chronic 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 infection. If the obstruction persists surgical intervention may be needed under general anesthesia.

For adults the ophthalmologist may clear the obstruction by irrigating the tear duct with saline solution and the use of antibiotic drops or ointment. Surgery is sometimes necessary (dacryocystorhinostomy) under general anesthesia to create a new passage for the tear flow.

Do not forget, my fellow readers, that you should not auto medicate and any sort of exploration that may be needed should be done exclusively by your ophthalmologist.

• Until next year; have a Merry Christmas and New Year full of vision!

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