Dacryocystitis
Also known as: Blocked Tear Duct, dacryostenosis
What
is it?
Dacryocystitis is an infection of the lacrimal
sac. This small sac sits at the inner corner of
the eye; tears drain into it from the eye and then
pass through the nasolacrimal ducts (often
referred to as tear ducts) and into the nose.
Who
gets it?
Dacryocystitis is a congenital (present from
birth) condition occurring in up to one third of
newborns.
What
causes it?
The infection is usually caused by blocked
nasolacrimal ducts (also called dacryostenosis).
In children who have dacryocystitis, tears are
unable to drain from the lacrimal sac, so they
pool in the eye and allow bacteria to grow,
leading to infection. Dacryocystitis is treated
with antibiotic eye drops or ointment and oral or
intravenous antibiotics if necessary.
What
are the symptoms?
Dacryocystitis occurs most often in infants,
and although it more commonly appears in one eye,
it can occur in both. The main symptoms are
excessive tearing or watering of the eye, even
when the child is not crying. The tearing is
usually accompanied by redness at the inner corner
of the eye and mild tenderness and a swelling or
bump at the side of the nose. Left untreated, this
redness may spread to other parts of the face.
These symptoms may also be accompanied by a fever.
Another symptom of dacryocystitis is pus or
mucus that collects in the corner of the eye. This
may cause your child to wake up with a crusting
over the eyelid or in the eyelashes.
If the infection is mild and left untreated,
most of the symptoms may disappear, with the
exception of some swelling. Fluid retention caused
by the infection may cause a large fluid-filled
sac called a mucocele to form under the skin. In
severe cases, this can cause an abscess that needs
to be drained surgically.
How
is it diagnosed?
If signs of infection are present, your child's
doctor may use a cotton swab to obtain a culture
from your child's eye. This can help to
distinguish dacryocystitis from other common eye
infections such as conjunctivitis. More commonly,
however, the doctor will be able to diagnose
dacryocystitis based on your child's symptoms and
will prescribe antibiotic drops or ointment
without taking a culture.
What
is the treatment?
In cases of severe infection, your child may be
admitted to the hospital and given antibiotics
intravenously. It's important to remember that
antibiotics do not get rid of an obstruction to
the tear duct; they only treat the resulting
infection.
Once the infection has cleared, your child's
doctor may ask you to perform daily massage of the
tear duct in order to try to remove the
obstruction. However, if your child suffers from a
severe infection or the infection recurs past the
age of 6 to 8 months, your child's doctor may
recommend an evaluation by a pediatric
ophthalmologist to see if your child needs a
surgical probe to open the blocked tear duct. If a
surgical probe is not successful, your child may
need further surgery.
Self Care Tips
In children with blocked tear ducts,
dacryocystitis may be prevented with regular
massage of the eye area, which may help to open
the blockage of the tear ducts. Most children's
tear ducts open by the time they're 1 year old,
which prevents excessive tearing, as well as the
infection.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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