Dacryocistitis

Question 1

Aetiology:

Answer 1

Inflammation of the lacrimal sac
Acute - due to infection (bacterial)
Chronic - due to blockage or poor potency of nasolacrimal duct caused by injury/ infection/congenital abnormality.

Question 2

Predisposing factors:

Answer 2

Congenital nasolacrimal duct blockage
F > M
Trauma / nasal surgery
Sinusitis

Question 3

Signs:

Answer 3

Swelling around lacrimal sac (inferior nasal)
Discharge from puncta mucopurulent
Differential diagnosis from inflammation only & no infection if just muscal discharge & no puss
Redness
Commonly present with preseptal cellulitis & conjunctivitis

Question 4

Symptoms:

Answer 4

Tender / painful @ site of swelling on lacrimal sac
Epiphora
Systemic fever
Acute onset

Question 5

Management by CLO:

Answer 5

Cease CL wear - refer
Referral (emergency)- infected dacryocistitis can quickly progress & risk of cellulitis
Refer emergency same day for kids or urgent to GP adults for antibiotics

Question 6

Differential diagnosis:

Answer 6

Cellulitis : - eyes should have good motility and movement with dacryocistitis
- red tissue should remain local to lacrimal sac