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Dacryocystitis (Inflammation of Lacrimal Sac) (Congenital…
Dacryocystitis (Inflammation of Lacrimal Sac)
Congenital (DACRYOCYSTITIS NEONATORUM )
Congenital blockage of Nasolacrimal duct
At it’s Lower End (Valve Of Hasner ) ( MOST COMMONEST CAUSE )
Epiphora after 7 days of Birth followed by Purulent Discharge
Massage over a Lacrimal Sac area & Topical Antibiotics (Mainstay Of Treatment )
Lacrimal Syringing ( Irrigation) with Normal Saline & Antibiotics Solution ( Conservative Treatment)
Dacryocystorhinostomy Operation
Positive Regurgitation Test
Adult ➡️ 1.Chronic (More Common)
Acute
Chronic DACRYOCYSTITIS
Predisposing Factors
40-60 years of Age
Predominantly in Females due to Narrow lumen of Canal
Whites > Negroes
Heredity
Low Sociopath Economic Status
POOR PERSONAL HYGIENE
Stasis Of tears in Lacrimal Sac
Anatomical ➡️ Partial Canalisation, Marrow Canal
Foreign Bodies in NLD
Excessive Lacrimation
Mild grade inflammation of Lacrimal Sac due to
Recurrent Conjunctivitis
Obstruction of Lower End Of NLD due to Nasal Disease ( Polyp)
Source of Infection
Conjunctiva , Paranasal Sinus , Nasal Cavity
Causative Organism
Staphylococcus, Streptococcus, Pneumococcus,Pseudomonas Pyocyanea
Tuberculosis , Syphillis , Rhiinosporoidiosis
Clinical Features of Chronic Dacryocystitis
1.Stage Of Chronic Catarrrhal Dacryocystitis
Mild inflammation of Lacrimal Sac
Blockage of NLD
Watering Eye 👁
Mucoid Fluid regurgitate
2.Stage of Lacrimal Mucocele
Epiphora
Distension Of Lacrimal Sac ( Due to stagnation ) & Blockage Of NLD ( Dacryocystography)
Gelatinous Mucoid Fluid Regurgitate
ENCYSTED MUCOCELE (/With NEGATIVE Regurgitation Test ) Due to blockage of both canaliculi due to Chronic Infection
3. Stage of Chronic Suppurative Dacryocystitis
Epiphora
Erythema Of skin over Lacrimal Sac
Purulent discharge due to Pyogenic infection
ENCYSTED PYOCELE
4. Stage of Chronic Fibrotic Sac
Complications of Chronic
High risk of Endophthlmitis if Intraocular surgery is performed in presence of it .
Chronic Intrctable Conjunctivitis
Ectropion
Of Lower eyelid
Treatment of Chronic
Conservative Treatment ( PROBING & LACRIMAL SYRINGING )
BALLON CATHETER DILATATION ( BALLON DACRYOCYSTOPLASTY)
DACRYOCYSTORHINOSTOMY (DCR )
DACRYOCYSTECTOMY
Indication
< 4 & > 60 years of aged Patient
Presence of Tuberculosis, Syphillis like Chronic infection
Shrunken & Fibrosed Lacrimal Sac
Atrophic Rhinitis
CONJUNCTIVODACRYOCYSTORHINOSTOMY ( when Blocked Camaliculi)
Acute Dacryocystitis
As an Acute exacerbation Of Chronic Dacryocystitis
As an Acute Peridacryocystitis due to Neighbouring Infection
Causative Organism ( Similar to Chronic)
Clinical Features
1.Stage Of Cellulitis ( Painful Swelling & Epiphora )
Topical antibiotics & NSAIDs
2. Stage of Lacrimal Abscess due to Pus collection*
Squeezing of Pus & DCT/ DCR Operation
3. Stage of Fistula Formation ➡️ External & Internally
DCT/ DCR Operation