Acute dacryocystitis is an inflammation of the lacrimal sac, characterized by painful swelling below the inner eye corner. It is caused by an obstruction of the nasolacrimal duct leading to infection, most commonly by Staphylococcus aureus or pneumococcus bacteria. If left untreated, the infection can progress through stages of cellulitis, abscess formation, and fistula formation draining pus externally or internally into the nasal cavity.

1. NR AISHWARYA
MBBS
PIMS

2.  Acute dacryocystitis is an acute suppurative
inflammation of the lacrimal sac,
characterized by presence of swelling in the
region of sac
 The term derives from the greek
dakryon(tear),cysta(sac),and it is(inflammation)
 The onset is acute,and there is painful swelling
below the inner canthus,often combined with
cellulitis

3.  Obstruction of nasolacrimal duct leads to
stasis of nasolacrimal fluid-infection
 Staphylococcus aureus –most common
 Pneumococcus

4. 3 Stages
 Stage of cellulitis
 Stage of lacrimal abscess
 Stage of fistula formation
Risk factor
 Age-more common between 40-60
years(lacrimal drainage system loses its
elasticity)
 Poor personal hygiene

5.  Characterized by a painful swelling in the
region of lacrimal sac
 Associated with epiphora,fever and malaise
 Swelling is red,hot,firm and tender
 Redness and edema spread to the lips and
cheek
 When treated resolution may occur

6.  Continous inflammation causes occlution of the
canaliculi due to oedema
 The space is filled with pus,distends and its
anterior wall ruptures forming a pericystic
swelling-large lacrimal abscess formed
 Points below and outer side of the sac-due to
gravitation of pus & medial palpebral ligament in
the upper part.

7. MEDIAL
PALPEBRAL
LIGAMENT

9.  When lacrimal abscess is left unattended-
discharge spontaneously-external fistula below
medial palpebral ligament
 Rarely, abscess may opens into the nasal cavity-
internal fistula

11.  Acute conjuntivities
 Corneal abrasion which may converted into
corneal ulcer
 Lid abscess
 Osteomyelitis of lacrimal bone
 Orbital cellulitis
 Facial cellulitis
 Rarely cavernous sinus thrombosis can occur