Dacryocystitis is an infection of the tear sacs or lacrimal sacs in the lower corner of the eye that can cause pain, redness, and discomfort.
Painful eyes with a gooey discharge are unpleasant for anyone dealing with them. Fortunately, symptoms resolve quickly with proper treatment. In this article, learn about what causes dacryocystitis and how to treat it.
Dacryocystitis is an inflammation or infection of tear sacs. These sacs are the upper portion of the tear ducts that run from the inside the corner of the eye down towards the nasal passages.
Tear ducts act as pathways that carry away the tears that have washed away dirt on the surface of the eyes. As the used tears move away from the eye through the tear ducts, fresh tears come in.
When there is a blockage in the tear sacs or tear ducts, this process gets disrupted, and used tears cannot travel away from the eye. Bacteria can then collect in the area.
As the symptoms of dacryocystitis are similar to many other eye infections, it is important that people see their doctor who can rule out more serious conditions and prevent the infection from spreading or causing complications.
Dacryocystitis is most common in infants. However, adults over the age of 40 also have a higher risk of developing dacryocystitis.
In infancy, congenital abnormalities of the tear ducts, such as a blockage in the tear duct that runs to the nasal passages, are a common cause of dacryocystitis.
Causes of dacryocystitis in older children and adults include:
- nasal abscess
- trauma to the region that causes a blockage
- tumors in the sinus or nasal passages
- bacteria that causes strep or staph infections
Dacryocystitis can be either acute or chronic. Symptoms of acute dacryocystitis start suddenly and often include fever and pus from the eye. Bacterial infections are usually the cause of acute dacryocystitis, and antibiotic treatment usually resolves the infection within a few days.
In cases of chronic dacryocystitis, the onset of symptoms may be more gradual. The symptoms are often less severe, and fever and pus may not be present. However, some people may experience long lasting pain or discomfort from the corner of the eye.
Chronic dacryocystitis may be caused by an obstruction in the tear ducts. In some severe cases of chronic dacryocystitis, surgery to widen the tear ducts may be needed to relieve symptoms.
Symptoms of dacryocystitis vary in intensity from person to person and depend on the type.
People with acute dacryocystitis often experience more severe symptoms than those with chronic dacryocystitis.
Both acute or chronic dacryocystitis can cause the following symptoms:
- pus and thick discharge from the eye
- pain in the lower outside corner of the eyelid
- redness and swelling near the lower outside eyelid
- watery eye
- excess tears
People with chronic dacryocystitis are less likely to experience pain, redness, or swelling.
Diagnosing dacryocystitis is relatively simple. During an exam, a doctor may ask for a person’s medical history and then access the eye for visible signs of dacryocystitis, such as swelling or redness.
A doctor may press on the lacrimal sac to see if pus comes out. If it does, the doctor may collect a sample of the pus to test for bacteria.
In some cases, a doctor may do a dye disappearance test. During this test, the doctor will place yellow dye in the corner of the eye. In a healthy eye, the yellow dye will disappear after a few minutes. If there is a blockage, the dye will linger in the eye for much longer.
The dye disappearance test can also indicate whether the tear ducts are partially or entirely blocked.
To check the level of blockage, a doctor will then swab inside the person’s nose on the side with the suspected blockage. If dye has passed through to the inside of the nose, it is likely to be a partial blockage.
Doctors usually only treat acute dacryocystitis when there is visible redness, cloudy discharge, or pus accompanied by a fever. In all age groups, acute dacryocystitis generally resolves quickly after taking oral antibiotics.
Some people may use topical antibiotics as well. Those who have more severe symptoms may require intravenous (IV) antibiotics.
In infants with recurrent cases of acute dacryocystitis, the tear ducts usually outgrow the blockage by the time they are 9 to 12 months old.
To treat chronic dacryocystitis, doctors may prescribe steroid eye drops to reduce swelling that may be obstructing the tear ducts.
However, people with chronic dacryocystitis may need to surgery to widen their tear ducts or bypass the blockage. This procedure, known as dacryocystorhinostomy, uses a laser to remove part of the bone, widening the pathway for tear ducts and removing any obstructions.
Most people with dacryocystitis can help relieve symptoms by using a warm compress on the outer part of the eye to help open up the ducts.
Also, over-the-counter pain relievers and anti-inflammatory medications may help manage pain and fever until definitive treatment with antibiotics or surgery takes place.
Most cases of acute dacryocystitis resolve with proper treatment and have no long-term effects.
People who experience recurrent outbreaks of dacryocystitis should see a doctor to be evaluated for chronic dacryocystitis. Cases of chronic dacryocystitis typically resolve after surgery or other interventional treatment.