Dacryocystitis

Dr Dan J Bell and Radswiki et al.

Dacryocystitis is the inflammation of the nasolacrimal sac related to impairment in the lacrimal drainage system and superimposed infection. 

Dacryocystitis has a bimodal distribution: neonates due to congenital abnormalities and, when acquired, usually affect individuals older than 40 years of age. 

Dacryocystitis is typically characterised by epiphora, erythema, and oedema in the region of the medial epicanthus and lacrimal puncta as the result of an infection of the nasolacrimal sac. There is often mucopurulent discharge from the puncta and associated conjunctivitis.

Obstruction or stricture of the nasolacrimal drainage is an underlying factor. 

Most cases in infants represent congenital abnormalities, such as incomplete canalisation or atresia of the nasolacrimal duct, dacryocele, and facial clefts. Whereas in adults it is usually the result of an acquired abnormality, including:

  • inflammation/infection
  • anatomic variation
    • enlarged turbinates 
    • nasal septal deviation
  • tumour
  • iatrogenic/trauma
  • foreign bodies

The microbiology of dacryocystitis mimics normal conjunctival flora in most instances.

In chronic dacryocystitis, there may be superinfection with fungal species.

They typically appear as well-circumscribed round lesions centred on the lacrimal fossa with peripheral enhancement.

Treatment is usually with antibiotics in the acute phase. In some cases, intervention (including external dacryocystorhinostomy) may be necessary.

Chronic dacryocystitis typically requires surgery or an interventional procedure.

Differentials on imaging include:

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Article information

rID: 12896
System: Head & Neck
Synonyms or Alternate Spellings:
  • Lacrimal sac inflammation
  • Inflammation of the lacrimal sac

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