Dacryocystitis
- Bacterial infection of lacrimal sac usually in infants when nasolacrimal passage fails to open normally
- In adults, caused by chronic sinusitis, facial trauma, or sinonasal neoplasm
- Delayed diagnosis may lead to permanent sac scarring and persistent tearing
- Painful, tender red mound overlying lacrimal sac
- Swelling and redness of surrounding lid tissue
- Mucopurulent discharge sometimes oozing out of lower punctum if you press on mound
- Orbital cellulitis, stye, BUT...
- Orbital cellulitis produces diffusely swollen upper and lower lids
- Stye, which rarely occurs in infants, displays focal lid swelling but not usually in region of lacrimal sac
- Consult ophthalmologist promptly
- Treatment consists of broad-spectrum systemic antibiotics
- Systemic antibiotic treatment may be successful; if not, incision and drainage may be necessary
- In infants, nasolacrimal probing may later be necessary
- In adults, cause of nasolacrimal duct obstruction must be determined
- If tearing persists, surgery to fashion alternative drainage channel (dacryocystorhinostomy) may be necessary