Treatment of Acute Dacryocystitis
Mar 20, 2022
Source: Cainiu Health
Dr. Cui Xin
Introduction
Treatment of Acute Dacryocystitis: The treatment aims to control infection, relieve pain, and restore patency of the obstructed nasolacrimal duct. In the early stage of acute dacryocystitis, local warm compresses, ultrashort-wave physical therapy, topical antibiotic eye drops, and systemic administration of antibiotics or sulfonamides may be employed. In neonates and infants, diagnosis of dacryocystitis is often challenging; therefore, hospitalization with intravenous antibiotic therapy is recommended.
Dacryocystitis is an inflammatory condition of the lacrimal sac caused by obstruction or stenosis of the nasolacrimal duct, or by infections originating from the nose, eyes, or systemic sources. It is classified into two types: acute dacryocystitis and chronic dacryocystitis. So, what are the treatment options for acute dacryocystitis? Let’s explore them together.
Treatment of Acute Dacryocystitis
Treatment aims to control infection, alleviate pain, and restore patency of the obstructed nasolacrimal duct. In the early stage of acute dacryocystitis, local warm compresses, ultrashort-wave physical therapy, topical antibiotic eye drops, and systemic administration of antibiotics or sulfonamides may be employed.
In neonates and infants, it may be difficult to distinguish dacryocystitis from orbital cellulitis; therefore, hospitalization with intravenous antibiotic therapy is recommended to reduce the risk of orbital abscess or sepsis.
If fluctuation is detected indicating abscess formation, incision and drainage should be performed, with placement of a drainage tube. Cultures of lacrimal sac contents should be obtained, and broad-spectrum antibiotic ointment applied topically. Once acute dacryocystitis has resolved, most patients should undergo dacryocystorhinostomy (DCR) surgery.
Symptoms of Dacryocystitis
1. Epiphora (Excessive Tearing)
Patients commonly present with epiphora, conjunctival injection, and mucoid or purulent discharge emanating from the punctum. Symptom severity varies depending on the clinical type: acute dacryocystitis typically has a sudden onset and more severe manifestations than chronic dacryocystitis. In chronic cases, accumulation of purulent material fosters proliferation of highly virulent bacteria—particularly Streptococcus pneumoniae and Streptococcus pyogenes.
2. Lacrimal Sac Swelling
In acute dacryocystitis, the lacrimal sac area appears erythematous, swollen, firm, tender, and markedly painful upon palpation. In chronic dacryocystitis, mild swelling and tenderness may be observed in the lacrimal sac region, along with localized skin erythema, erosion, or thickened, roughened skin; eczema of the lower eyelid may also occur. Additionally, acute exacerbations may be accompanied by preauricular lymphadenopathy and, in severe cases, systemic symptoms such as chills and fever.
We hope the above information is helpful to you.
