Table of ContentsView AllTable of ContentsHow Tears Are ProducedTypes of DacryocystitisSymptomsCauses and Risk FactorsDiagnosisDifferential DiagnosisTreatment

Table of ContentsView All

View All

Table of Contents

How Tears Are Produced

Types of Dacryocystitis

Symptoms

Causes and Risk Factors

Diagnosis

Differential Diagnosis

Treatment

Dacryocystitis refers to an infection of the tear sacs, which are part of the tear drainage system in the eye. Tears drain from each eye through small canals (drainage canals), a tear sac, and a tear duct. Drainage canals are found at the inner corner of each upper and lower eyelid, and they carry away tears that have rinsed the front surface of the eye. These canals empty into the tear sac, also known as the lacrimal sacs, through which tears move into the tear duct (nasolacrimal duct) and then into the nose.

The usual cause of dacryocystitis is a blockage in the tear duct and backup of tears in the tear sac. The tear sac can become inflamed and swell, resulting in dacryocystitis. This condition often triggers watery eyes, redness, and eye discharge.

Corbis/ VCG/ Getty Images

man with a tear duct infection rubbing eyes and bridge of nose

When this drainage system is partially or completely obstructed, tears cannot be drained, resulting in an infection.

The Eye Lens' Function and Structure

Tear duct infection can be classified as acute, chronic, congenital, or acquired. Acute and chronic refer to the duration of symptoms, while congenital and acquired refer to the onset and cause of the condition.

Each type of dacryocystitis has different characteristics:

Neoplasm Types and Factors That Cause Them

Who Gets Dacryocystitis?Although dacryocystitis can occur at any age, it is more common in newborns and adults over 40. Congenital dacryocystitis is a common pediatric problem, and is present in up to 1.2% to 20% of newborns.However, most cases disappear before the first year.Adults over 40 years old have higher chances of developing acute dacryocystitis. Older age leads to narrowing of the punctal openings, slowing tear drainage and increasing the risk of tear duct obstruction. In adults, females are more commonly affected than males, and Caucasians are more commonly affected than African Americans.

Who Gets Dacryocystitis?

Although dacryocystitis can occur at any age, it is more common in newborns and adults over 40. Congenital dacryocystitis is a common pediatric problem, and is present in up to 1.2% to 20% of newborns.However, most cases disappear before the first year.Adults over 40 years old have higher chances of developing acute dacryocystitis. Older age leads to narrowing of the punctal openings, slowing tear drainage and increasing the risk of tear duct obstruction. In adults, females are more commonly affected than males, and Caucasians are more commonly affected than African Americans.

Although dacryocystitis can occur at any age, it is more common in newborns and adults over 40. Congenital dacryocystitis is a common pediatric problem, and is present in up to 1.2% to 20% of newborns.However, most cases disappear before the first year.

Adults over 40 years old have higher chances of developing acute dacryocystitis. Older age leads to narrowing of the punctal openings, slowing tear drainage and increasing the risk of tear duct obstruction. In adults, females are more commonly affected than males, and Caucasians are more commonly affected than African Americans.

Dacryocystitis symptoms are often mild, but in severe cases, it can cause a fever. An abscess (a collection of pus) can form and rupture through the skin.

The symptoms of acute and chronic dacryocystitis are different, however.

Acute

Acute dacryocystitis will often have sudden symptoms, and they may occur over several hours to several days.

Symptoms often appear over the medial canthus (the point where the upper and lower eyelids meet) and the area overlying the lacrimal sacs, and they include:

Chronic

The most common symptoms of chronic dacryocystitis are excessive tearing and discharge. People with this kind of dacryocystitis may also notice changes in visual acuity due to tear film production.

Complications

The blocked tear ducts are easy to treat and symptoms improve with treatment in most cases. Although it is uncommon, some cases of acute dacryocystitis can lead to complications, including:

The consequences of these complications can be devastating, so a prompt referral to an ophthalmologist for evaluation is important.

Symptoms of Meningitis

Causes

Risk Factors

Some factors increase the chances of a person developing dacryocystitis:

The diagnosis of dacryocystitis is primarily based on history and physical exams. An eye specialist may request additional tests to rule out other conditions and confirm the diagnosis.

Different tests and exams will be used to diagnose the different types of dacryocystitis.

Lab Tests

People with chronic cases of dacryocystitis will need serologic testing since systemic conditions are suspected.For example, antineutrophil cytoplasmic antibody (ANCA) testing may be useful to test for Wegener’s granulomatosis, while antinuclear antibody testing (ANA) and double-stranded DNA (dsDNA) can be used if lupus is suspected.

In acute cases, a Crigler massage can be performed to obtain a sample for culture and gram stain.

How Lupus Is Diagnosed

Eye Exam

During an eye exam, your healthcare provider will measure the production of tears, as well as the position and function of the eyelids and eyelid muscles. They will also perform an irrigation test to determine whether the tear ducts are indeed blocked.

What Is an Eye Exam?

Imaging

Imaging is not typically needed for diagnosis unless suspicion arises on history and physical (for example, patienthas bloody tears). It may also be recommended for those who are acutely toxic or experience visual changes, along with bloodwork.CT scansmay be taken in cases of orbital cellulitis or extensive infection. Dacryocystography or plain film dacrosystogram (DCG) can be performed when anatomic abnormalities are suspected.Nasal endoscopy is used to exclude problems such as septal deviation or inferior meatal narrowing.

Some diseases that have similar symptoms to dacryocystitis are:

Home Remedies

Some home remedies can help to relieve the symptoms and treat acute dacryocystitis:

Medication

Antibiotics are prescribed for some cases of acute dacryocystitis. Oral antibiotics can treat the condition quickly. A severe infection requires initial IV antibiotics and observation in the hospital.

If a person with acute dacryocystitis has worsening symptoms, even with oral antibiotics or shows evidence of orbital cellulitis, they may be given IV antibiotics.

Surgical Procedures

Surgery is typically used to treat chronic cases of dacryocystitis. There are different types of surgeries, and the patient should discuss with the healthcare provider the best options:

8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Ophthalmology.Facts about tears.American Academy of Ophthalmology.Dacryocystitis.Davies R, Watkins WJ, Kotecha S, Watts P.The presentation, clinical features, complications, and treatment of congenital dacryocystocele.Eye (Lond). 2018;32(3):522-526. doi:10.1038/eye.2017.235Pinar-Sueiro S, Sota M, Lerchundi TX, et al.Dacryocystitis: systematic approach to diagnosis and therapy.Curr Infect Dis Rep. 2012;14:137–146. doi:10.1007/s11908-012-0238-8Merck Manual.Dacryocystitis[professional version].Harvard Health Publishing.Tear duct infection (dacryocystitis).Petris C, Liu D.Probing for congenital nasolacrimal duct obstruction.Cochrane Database Syst Rev. 2017;7(7):CD011109. doi:10.1002/14651858.CD011109.pub2Hull University Teaching Hospitals NHS Trust.Information for patients on dacryocystorhinostomy (DCR).

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Ophthalmology.Facts about tears.American Academy of Ophthalmology.Dacryocystitis.Davies R, Watkins WJ, Kotecha S, Watts P.The presentation, clinical features, complications, and treatment of congenital dacryocystocele.Eye (Lond). 2018;32(3):522-526. doi:10.1038/eye.2017.235Pinar-Sueiro S, Sota M, Lerchundi TX, et al.Dacryocystitis: systematic approach to diagnosis and therapy.Curr Infect Dis Rep. 2012;14:137–146. doi:10.1007/s11908-012-0238-8Merck Manual.Dacryocystitis[professional version].Harvard Health Publishing.Tear duct infection (dacryocystitis).Petris C, Liu D.Probing for congenital nasolacrimal duct obstruction.Cochrane Database Syst Rev. 2017;7(7):CD011109. doi:10.1002/14651858.CD011109.pub2Hull University Teaching Hospitals NHS Trust.Information for patients on dacryocystorhinostomy (DCR).

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Academy of Ophthalmology.Facts about tears.American Academy of Ophthalmology.Dacryocystitis.Davies R, Watkins WJ, Kotecha S, Watts P.The presentation, clinical features, complications, and treatment of congenital dacryocystocele.Eye (Lond). 2018;32(3):522-526. doi:10.1038/eye.2017.235Pinar-Sueiro S, Sota M, Lerchundi TX, et al.Dacryocystitis: systematic approach to diagnosis and therapy.Curr Infect Dis Rep. 2012;14:137–146. doi:10.1007/s11908-012-0238-8Merck Manual.Dacryocystitis[professional version].Harvard Health Publishing.Tear duct infection (dacryocystitis).Petris C, Liu D.Probing for congenital nasolacrimal duct obstruction.Cochrane Database Syst Rev. 2017;7(7):CD011109. doi:10.1002/14651858.CD011109.pub2Hull University Teaching Hospitals NHS Trust.Information for patients on dacryocystorhinostomy (DCR).

American Academy of Ophthalmology.Facts about tears.

American Academy of Ophthalmology.Dacryocystitis.

Davies R, Watkins WJ, Kotecha S, Watts P.The presentation, clinical features, complications, and treatment of congenital dacryocystocele.Eye (Lond). 2018;32(3):522-526. doi:10.1038/eye.2017.235

Pinar-Sueiro S, Sota M, Lerchundi TX, et al.Dacryocystitis: systematic approach to diagnosis and therapy.Curr Infect Dis Rep. 2012;14:137–146. doi:10.1007/s11908-012-0238-8

Merck Manual.Dacryocystitis[professional version].

Harvard Health Publishing.Tear duct infection (dacryocystitis).

Petris C, Liu D.Probing for congenital nasolacrimal duct obstruction.Cochrane Database Syst Rev. 2017;7(7):CD011109. doi:10.1002/14651858.CD011109.pub2

Hull University Teaching Hospitals NHS Trust.Information for patients on dacryocystorhinostomy (DCR).

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