This document discusses chronic dacryocystitis, an inflammation of the lacrimal sac caused by blockage and infection. It identifies potential predisposing factors and causes, including age, anatomy, foreign bodies, and common infectious organisms like Staphylococci. The condition progresses through stages from chronic catarrhal dacryocystitis to lacrimal mucocoele and chronic suppurative or fibrotic sac stages. Potential complications include conjunctivitis, ectropion, and corneal ulcers. Treatment options include lacrimal syringing, balloon dilation, dacryocystorhinostomy surgery, or dacryocystectomy if other options are contraindicated.
Dacryocystitis is an infection or inflammation of the nasolacrimal sac, usually accompanied by blockage of the nasolacrimal duct. Dacryocystitis can be acute or chronic and congenital or acquired.
Dacryocystitis is an infection or inflammation of the nasolacrimal sac, usually accompanied by blockage of the nasolacrimal duct. Dacryocystitis can be acute or chronic and congenital or acquired.
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2. • WHAT IS DACRYOCYSTITIS?
• WHAT ARE THE CAUSES OF
CHRONIC DACRYOCYSTITIS?
Predisposing Factors
Factors causing stasis of tears
Source of infection
Causative organisms
3. 1. Predisposing factors
• Age
• Sex
• Race
• Heredity
• Socio-economic status
• Poor personal hygiene
4. 2. Factors causing stasis of tears
• Anatomical factors
• Foreign bodies
• Excessive
lacrimation
•Mild grade
inflammation
•Obstruction of
lower end of NLD
6. 4. Causative organisms
• Most common –
Staphylococci,
Pneumococci,
Streptococci,
Pseudomonas
pyocyanea
7. STAGES
1. Stage of chronic catarrhal
dacryocystitis
2. Stage of lacrimal mucocoele
3. Stage of chronic
suppurative dacryocystitis
4. Stage of chronic fibrotic sac
8. 1. Stage of chronic catarrhal
dacryocystitis
• Symptoms
• Lacrimal syringing –
clear fluid or few
fibrinous flakes
• Dacryocystography –
block in the NLD, normal
sized lacrimal sac with
healthy mucosa
9. 2. Stage of lacrimal mucocoele
• Symptoms
• Dacryocystography –
distended sac with blockage
in the NLD
• Regurgitation test – milky or
gelatinous fluid
•Encysted mucocoele
10. 3. Stage of chronic suppurative
dacryocystitis
• Symptoms
• Regurgitation test – frank
mucopurulent discharge
• Encysted pyocoele
4. Stage of chronic fibrotic sac
• Symptoms
• Dacryocystography – very
small sac with irregular
mucosal folds
11. COMPLICATIONS
• Chronic intractable conjunctivitis
• Ectropion of lower lid, maceration
and eczema of lower lid skin
• Hypopyon corneal ulcer
• Operative complications -
endophthalmitis
12. TREATMENT
• Conservative treatment – repeated lacrimal
syringing
• Balloon catheter dilation
• Dacryocystorhinostomy
• Dacryocystectomy – only when DCR is
contraindicated
• Conjunctivodacryocystorhinostomy