Its a quick revision on Acute Dacryocystitis for Exam point of view! The slides are made in such a way that you can answer questions in exams easily

1. Quick review on
Acute Dacryocystitis
By Priyanka (3rd year Medical Student)

3. Here we can appreciate the Lacrimal sac!

4. • An acute suppurative inflammation of
lacrimal sac starting from pericystic region
and characterized by a painful swelling in
this region.

6. Causes
• Streptococcus
• Staphylococcus
• pneumococcus

7. Types
• Spontaneous- without any prior history of
epiphora
• Acute- history of chronic dacryocystitis

8. Spread
• Direct spread – sinusitis, rhinitis
• Post traumatic- fracture nasal bone, maxilla
• Nasolacrimal duct obstruction
• Blood borne infection

9. Stage of preseptal cellulitis
• Signs of inflammation- red, warm, tender
• Swelling over inflammed site
• Epiphora
• Fever & malaise
• Spread of swelling over lids & cheeks
• Conjunctival congestion & chemosis

11. Stage of lacrimal abscess
• Obstruction of canaliculi
• Accumulation of pus in lacrimal sac
• Distended & fluctuant swelling
• Pus pointing below & outwards
• Sac ruptures  pericystic swelling

12. Lacrimal abscess

13. Stage of fistula formation
• Rupture of sac
• If via skin external fistula
• If via nasal mucosa internal fistula

14. External lacrimal fistula

15. Management
• Stage wise management
1st stage
• Ciprofloxacin 500 mg BD 2 wks
• Amoxicillin 2 wks
• Paracetamol or ibuprofen 5 days
• Hot fomentation TDS 1 wk

16. 2nd stage
• Same medicines a s 1st stage
• If pointing, small incision on skin  drainage
of abscess  apply dressing with betadine
soaked gauze
• To prevent recurrences dacryocystectomy or
dacryocystorhinostomy done

17. 3rd stage
• Systemic antibiotics
• Fistulectomy + DCT / DCR
• In nasolacrimal duct obstruction DCR done

18. Complications
• Acute conjunctivitis
• Corneal ulcer
• Lid abscess
• Orbital cellulitis
• Facial cellulitis
• Osteomyelitis of lacrimal bone
• Acute ethmoiditis

19. Thank You!