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Dacryocystitis - External and Internal Eye
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Dacryocystitis - External and Internal Eye

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Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
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Synopsis

This summary discusses dacryocystitis in adults and children. Dacryocystitis in neonates is addressed separately.

Dacryocystitis refers to inflammation of the lacrimal sac and/or lacrimal excretory apparatus. It may be acute or chronic. The most common cause of dacryocystitis in adults is lacrimal duct stenosis with stagnation of lacrimal excretions and resultant infection. The most commonly identified bacterial isolates are species of staphylococci and streptococci, but gram-negative organisms and anaerobes may also cause the condition.

Acute dacryocystitis usually presents with the sudden onset of pain, swelling, and erythema at the medial canthal region. Chronic dacryocystitis most commonly manifests as the insidious onset of epiphora (excessing tearing). Most often, the site of obstruction is nasal rather than ocular (nasal tumors or foreign bodies, congenital malformations, inflamed nasal mucosa, post-traumatic anatomic abnormalities, etc). Other conditions and treatments that may predispose to lacrimal outflow obstruction include chemotherapy, radiation, lymphoma, granulomatosis with polyangiitis, sarcoidosis, and cicatricial pemphigoid.

Acute dacryocystitis may lead to formation of a lacrimal sac abscess and spread of the infection to the orbit with subsequent orbital cellulitis. Treatment is with topical and systemic antibiotics acutely; definitive treatment often requires surgery. In adults, dacryocystitis is more common in middle-aged to older women. It occurs less frequently in blacks than in whites due to slight anatomic differences between the races.

Codes

ICD10CM:
H04.309 – Unspecified dacryocystitis of unspecified lacrimal passage

SNOMEDCT:
85777005 – Dacryocystitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 06/15/2018
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Dacryocystitis - External and Internal Eye
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Dacryocystitis : Eye pain, Erythema, Eyelid edema, Inferior eyelid, Medial canthus, Periorbital edema, Lacrimal gland enlarged, Excessive tearing, Mucopurulent eye discharge
Clinical image of Dacryocystitis
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