Definition: Acute suppurative inflammation of the lacrimal sac.
Etiology
Predisposing factors:
• Nasolacrimal duct obstruction • Chronic dacryocystitis.
Causative agent:
• Pneumococci
• Staphylococci
• Streptococci.
Symptoms
1. Severe pain.
2. Fever.
3. Epiphora.
Signs
1. Tender swelling of the lacrimal sac.
2. Marked edema & redness of the skin over the sac.
3. Regurgitation test: Reflux of pus, unless pericystitis occurs.
4. Abscess formation with fluctuation.
Complications
1. Lacrimal fistula: Anterior bursting of the sac through the skin.
2. Pyocele: Obstruction of the canaliculi ===> distension of the sac with pus.
3. Orbital cellulites: Ending in optic nerve atrophy blindness.
4. Cavernous sinus thrombosis (CST).
5. Chronic dacryocystitis.
Treatment
1. During the acute phase:
• Systemic & topical antibiotics.
• Hot fomentations.
• Lotions: To clear pus.
• Incision & drainage: If an abscess forms.
2. After subsidence of the acute attack:
Dacryocystorhinostomy (DCR) with or without fistulectomy.
Predisposing factors:
• Nasolacrimal duct obstruction • Chronic dacryocystitis.
Causative agent:
• Pneumococci
• Staphylococci
• Streptococci.
Symptoms
1. Severe pain.
2. Fever.
3. Epiphora.
Signs
1. Tender swelling of the lacrimal sac.
2. Marked edema & redness of the skin over the sac.
3. Regurgitation test: Reflux of pus, unless pericystitis occurs.
4. Abscess formation with fluctuation.
Complications
1. Lacrimal fistula: Anterior bursting of the sac through the skin.
2. Pyocele: Obstruction of the canaliculi ===> distension of the sac with pus.
3. Orbital cellulites: Ending in optic nerve atrophy blindness.
4. Cavernous sinus thrombosis (CST).
5. Chronic dacryocystitis.
Treatment
1. During the acute phase:
• Systemic & topical antibiotics.
• Hot fomentations.
• Lotions: To clear pus.
• Incision & drainage: If an abscess forms.
2. After subsidence of the acute attack:
Dacryocystorhinostomy (DCR) with or without fistulectomy.
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