Dacryocystitis

Dacryocystitis is a type of eye infection that causes mild to acute discomfort in the eyes. Know all about this infection – its causes, symptoms, diagnosis, possible treatment options and more.

Dacryocystitis Definition

Also known as Inflamed Tear Ducts and Tear Duct Infection, it is an ocular infection that affects the tear ducts or the tear sac (Lachrymal sac) in one or both eyes. It causes excessive tearing and redness of the infected eye. This infection affects both males and females alike. People from all age groups may be affected by this condition although it is more common in infants. Adults may also develop this infection.

Dacryocystitis Causes

In some adults, the tear ducts get blocked due to the natural growth of the surrounding bones. The bones grow and constrict the tear ducts, ultimately causing a complete blockage which allows growth of various bacteria in the obstructed area. This gradually leads to the infection.

In adults, the bacteria Staphylococcus aureus and beta-hemolytic streptococci (occasionally) mainly lead to an acute Tear Duct Infection. The chronic form of the condition is caused by the Streptococcus pneumonia bacteria or Actinomyces or Candida albicans fungus. Primary as well as secondary tumors of nose and sinus may also give rise to this infection.

Tear Duct Infection is commonly seen as a congenital condition. Newborn babies often have a membrane in their tear ducts that remains closed or allow just a narrow passage for the tears. This condition is very common in infants and is generally outgrown by the time they become 1 year old.

Dacryocystitis Signs and Symptoms

Following are the common symptoms of this condition both in adults and infants:

  • Excessive watering or tearing of the eye, even when a patient is not crying
  • Redness of the sides of the nose that is close to the inner corner of the affected eye
  • Tenderness of the side of the nose near the inner corner of the affected eye
  • Bumps and swelling in the affected sides of the nose
  • Fever, in some cases
  • Build-up of mucus or pus in the corner of an affected eye
  • Development of crusts over the eyelashes and eyelids after sleep

If left untreated, it can increase the risks of various bacterial infections. These infections can lead to different health problems, such as fever and acute infection in some other part of the body.

Dacryocystitis Diagnosis

Doctors perform certain examinations to check whether there are any signs of redness and swelling at the corner of an affected eye, discharge of pus or excessive tear release. Examiners may also ask patients whether they have been suffering from fever. Discharge of pus or mucus when the tear sac or lacrimal sac is pressed can help to confirm the presence of infection. Doctors may collect a sample of the pus to test it and identify the bacteria or fungus that is causing the infection.

If the physical signs are unable to confirm the presence of Tear Duct Infection, or if the diagnosis requires further confirmation, a dye disappearance test might be performed. In this test, a doctor places a fluorescent yellow dye at the corner of the affected eye and allows it to blend with the tears. The dye is likely to disappear from the surface of the eye after some time if the patient has a properly functioning tear drainage system. A cotton swab is used for ascertaining if any yellow dye has entered the tear duct. This test helps physicians to understand whether the tear duct of a patient is blocked partially or completely. Physicians may use x-ray during the dye disappearance test to identify the exact location of the obstruction.

X-ray examination of the facial bones and nose can also help in the determination of any bone fracture or structural deformity of the bones. CT (Computed Tomography) scans of the orbit and paranasal sinuses help to detect any blockage in the lacrimal duct.

Dacryocystitis Differential Diagnosis

A differential diagnosis of this infection aims at telling its signs apart from various other conditions that display similar symptoms. Such disorders include:

  • Alacrima
  • Actinomycosis
  • Basal Cell Carcinoma (Eyelid)
  • Preseptal Cellulitis
  • Adult Blepharitis
  • Orbital Cellulitis
  • Bacterial Conjunctivitis
  • Chalazion
  • Neonatal Conjunctivitis
  • Primary Congenital Glaucoma
  • Episcleritis
  • Headache (in children)
  • Canalicular Laceration
  • Congenital Anomalies of the Nasolacrimal Duct
  • Conjunctival Melanoma
  • Nasolacrimal Duct Obstruction
  • Red Eye Evaluation
  • Optic Neuropathy (Compressive)
  • Sarcoidosis
  • Squamous Cell Carcinoma (Eyelid)

Dacryocystitis Treatment and Surgery

This condition is completely curable in the majority of cases. The treatment for both acute and chronic Dacryocystitis depends on the severity of the symptoms and the age of a patient. One should consult his or her doctor about the most suitable treatment plan. Some of the treatment options for Tear Duct Infection are:

Antibiotics and Other Medications

Oral antibiotics, like Augmentin, are the standard treatment options for Dacryocystitis. These antibiotics are able to clear even acute infections within a short time. These medicines are also useful for relieving the symptoms of the chronic form. In most cases, antibiotics are sufficient for clearing up the infection quickly. However, eye drops and over-the-counter antibiotic ointments are required in some cases to manage the condition. But one should take care that the ointments do not get into the eyes as some of them contain certain ingredients that can cause eye irritation.

Surgery

Doctors may recommend a minor surgery if antibiotics fail to treat the infection properly. The various surgical treatment options, used for treating Tear Duct Infections, are:

Surgical examination of the tear duct

It is done by guiding a thin wire through the patient’s tear duct for clearing out the blockage. This surgery procedure is most commonly used for curing recurring infections in babies.

Dacryocystorhinostomy

It is a process that is used for expanding the blocked or narrowed tear ducts. This surgery generally uses laser for removing the bone causing the blockage.

The infection can also be treated by another surgery in which the entire lacrimal sac is removed.

Homeopathy

One can try proper homeopathic medicines for treating this infection as these drugs have been found to successfully cure the condition in some people.

Dacryocystitis Home Remedies

There are various home treatment options that are used for keeping the symptoms in check:

  • One can use a piece of clean cloth dipped in lukewarm water to press on the swelling in the affected eye.
  • Herbal eyewashes can help to reduce the irritation due to infection. One teaspoon full of dried Eyebright herb has to be soaked in boiling water (1 pint). The mixture has to be strained for extracting the herb’s essence, which is used as herbal eyewash.
  • A warm compress containing rose and chamomile oil is also used for curing the infection.
  • The herb Aloe Vera can be used for soothing the irritation in the infected eyes. One can soak a clean cloth in the extract of this herb and apply it over the eyes.
  • Tea, made from the blossoms of the Elderberry herb, has been found to be effective in treating Dacryocystitis. One teaspoon-full dried blossoms of Elderberry plants has to be brewed in half cup of water to make a decoction. This decoction is used as eyewash for the infected eyes.
  • Using eyewash containing water and honey is another home remedy for this condition. Three tablespoons of honey has to be added to two cups of boiled water. The mixture is used for washing the eyes once it is cold.

Dacryocystitis Complications

In some cases, an abscess forms and ruptures that causes drainage through the new opening. This condition is known as Fistula. Pneumococcal bacteria may infect the area, causing Dacryocystitis. This condition may even traumatize the cornea, causing Corneal Ulcer. If an acute Dacryocystitis keeps recurring, it may cause a brawny, red and hardened area or induration over the tear sac. Chronic Tear Duct Infection may also cause infection of the surrounding tissues and lead to Orbital Cellulitis.

Dacryocystitis Prognosis

The outcome of this treatment depends on the factors causing the condition. However, there are different treatment options for any type of Dacryocystitis in both adults and infants. Hence, the prognosis is positive in most cases. Majority of infants born with blocked tear ducts outgrow the problem when they become 1 year old.

Dacryocystitis Prevention

There are no known ways to prevent a Tear Duct Infection as infants are often born with the membrane that blocks the tear ducts and causes this condition. It is not possible to prevent the natural growth of the bones that blocks the tear sac in adults. However, one can follow a routine of putting pressure on the tear sac and applying warm compresses to make Dacryocystitis less frequent in children prone to the infection.

Dacryocystitis Pictures

The following images show how this infection affects the external appearance of an infected eye.

Picture of Dacryocystitis

Picture 1 – Dacryocystitis

Image of Dacryocystitis

Picture 2 – Dacryocystitis Image

Timely diagnosis and proper treatment can cure this condition completely. There are various support groups that provide guidelines about how to manage this type of infection in children and adults.

References:

http://www.online-health-care.com/diseases/dacryocystitis.htm

http://www.sparkpeople.com/resource/health_a-z_detail.asp?AZ=130

http://www.bausch.com/en/Eye-concerns/Eye-infections-irritations/Inflamed-tear-ducts

http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9784.html

http://pediatrics.med.nyu.edu/conditions-we-treat/conditions/dacryocystitis#risk

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