Dacryocystitis
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- 3 chapters
Related on Lably
Through Infection, Tears and Antibiotic
Signs and symptoms
- Pain, swelling, redness over the lacrimal sac at medial canthus
- Tearing, crusting, fever
- Digital pressure over the lacrimal sac may extrude pus through the punctum (also called roplas test positive)
- In chronic cases, tearing may be the only symptom
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Pathophysiology
A variety of causes may lead to dacryocystitis. Most notably, obstruction of the nasolacrimal duct leads to stasis of the nasolacrimal fluid, which predisposes to infection. Staphylococcus aureus is a common bacterial pathogen causing infectious dacryocystitis. Sometimes, especially in women, stones may develop in the lacrimal gland, causing recurrent bouts of dacryocystitis; this condition is called "acute dacryocystic retention syndrome." Also due to pneumococcus, infection due to surrounding structure such as paranasal sinuses.
Prognosis
About 60 percent of initial attacks of dacryocystitis will recur. Individuals with a poorly functioning immune system (immunocompromised) may develop orbital cellulitis, which may lead to optic neuritis, proptosis, motility abnormalities, or blindness.