Dacryocystitis
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Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of the lacrimal sac.[1] The term derives Template:Ety.[2] 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 dacryocystocele. It is most commonly caused by Staphylococcus aureus and Streptococcus pneumoniae.[3] The most common complication is corneal ulceration, frequently in association with S. pneumoniae.[3] The mainstays of treatment are oral antibiotics, warm compresses, and relief of nasolacrimal duct obstruction by dacryocystorhinostomy.[3]
Signs and symptoms
- Pain, swelling, redness over the lacrimal sac at medial canthus [4]
- Tearing, crusting, fever
- Digital pressure over the lacrimal sac may extrude pus through the punctum (also called roplas test positive)
- In chronic cases, tearing may be the only symptom
Pathophysiology
A variety of causes may lead to dacryocystitis. 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 dacryocystitis.[5] Sometimes, especially in women, stones may develop in the lacrimal gland, causing recurrent bouts of dacryocystitis; this condition is called "acute dacryocystic retention syndrome."[5] Also due to pneumococcus, infection due to surrounding structure such as paranasal sinuses.
Prognosis
About 60 percent of initial attacks of dacryocystitis will recur.[5] Individuals with a poorly functioning immune system (immunocompromised) may develop orbital cellulitis, which may lead to optic neuritis, proptosis, motility abnormalities, or blindness.[5]
See also
References
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External links
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