Dacryocystitis is the inflammation of the lacrimal sac, occurring in congenital and acquired forms, with chronic acquired being the most common. Predisposing factors include age, sex, race, heredity, socio-economic status, and poor hygiene, while various causative organisms lead to distinct clinical features across four stages. Treatment options include conservative methods and surgical interventions such as dacryocystorhinostomy or dacryocystectomy.

1. DACRYOCYSTITIS
DR ATHIRA AJITH

2. DACRYOCYSTITIS
 IT IS THE INFLAMMATION OF LACRIMAL SAC USUALLY OCCUR IN TWO FORMS
 CONGENITAL
 ACQUIRED
 ACQUIRED IS AGAIN DIVIDED INTO TWO TYPES
 ACUTE DACRYOCYSTITIS
 CHRONIC DACROCYSTITIS

3. Chronic Dacyocystitis
 IT is moST common.
 Etiology:
 Age (between 40 and 60 years), sex (female 80%), Race (white), heredity.
Socio-economic status (low) and poor personal hygeine play as predisposing
factors.
 Factors responsible for stasis of tears in lacrimal sac include anatomical
factore, foreign bodies in the sac, excessive lacrimation. mild grade
inflammation of lacrimal sac and obstruction of lower end of nasolacrimal duct
(NLD). Source of infection may be conjunctiva, nasal cavity or paranasal
sinuses.

4.  Causative organisms:
Staphylococci, Pneumococci, Streptococci and Pseudomonas
Clinical features may be divided into four stages:•
Stage of chronic catarrhal dacryocystitis:
Only symptom is watering eye and sometimes mild redness in inner canthus.
• Stage of lacrimal mucocele:
Milky or gelatinous mucoid fluid regurgitates from the lower punctum on pressing the
newly developed swelling.

5.  Stage of chronic suppurative dacryocystitis:
On regurgitation, a frank purulent discharge flows from the lower punctum.
Stage of chronic fibrotic sac:
Low grade repeated infections for a prolonged period ultimately result in small
fibrotic sac due to thickening of the mucosa. There will be persistent epiphora and
discharge.

6. Complications:•
 Chronic intractable conjunctivitis.•
 • Simple corneal abrasions may become infected leading to hypopyon
ulcer.
 Ectropion, maceration and eczena of lower lid
 .• If an Intraoccular surgery is performed in the presence of dacryocystitis,
there is a high risk of developing endophthalmitis.

7. Treatment :•
 Conservative treatment like repeated lacrymal syringing is useful in recent
cases.
 • Dacryo cysto rhinostomy (DCR) is the operation of choice
 .• Dacryo cystectomy (DCT)