Are your eyes sore or swollen? It could be Dacryocystitis!

Is the inside of your eye , near your nose, swollen, red, and sometimes painful with pus? Or does your little one's eyes seem to be constantly watering, or do they have lumps of tear in the corners of their eyes? These could be signs of a condition called dacryocystitis. Don't worry, we'll talk about this in detail and very simply today.

What is Dacryocystitis?

Simply put, Dacryocystitis is an inflammation or infection of our lacrimal sac . Now you may be wondering what this lacrimal sac is and where it is located.

Our eyes produce tears. These tears help keep our eyes moist and clean. Normally, these tears drain through a small opening (also called a `punctum`) at the inner corner of the eye , and then through a small tube into the tear sac. From this tear sac, another tube, called the `nasolacrimal duct`, goes to the nose. That's why you get teary tears when you cry.

However, if the tear duct, either in the lacrimal sac or the tear duct , becomes blocked for some reason, the tears cannot flow through and get stuck in one place. When this happens, germs can grow in the tear fluid and become infected. That's what we call dacryocystitis.

What is the difference between acute and chronic dacryocystitis?

There are two main types of dacryocystitis: acute dacryocystitis and chronic dacryocystitis .

• Acute dacryocystitis: This is a sudden onset. Symptoms appear suddenly and usually resolve within three months. Symptoms may include pain, swelling, and redness.
• Chronic dacryocystitis: This is a more long-term condition. Symptoms may be less severe than in acute dacryocystitis, but there may be prolonged tearing and occasional minor swelling.

Another thing is that chronic dacryocystitis can sometimes be associated with other conditions that affect our entire body. For example, it can be seen with autoimmune conditions such as Granulomatosis with Polyangiitis, Sarcoidosis, and Lupus (also known as Systemic Lupus Erythematosus). It can also occur in people with chronic red eyes, such as chronic conjunctivitis, or Pink Eye.

The types of germs (pathogens) that cause infection in these two types may also differ.

Are there other types?

Yes, in addition to acute and chronic types, this condition can be congenital or acquired .

• Congenital Dacryocystitis: This most often occurs in young babies. This occurs because the amniotic fluid in the tear ducts does not completely drain while the baby is in the womb. If this fluid becomes infected, it is called neonatal dacryocystitis .

Imagine, there is a newborn baby, let's say his name is Uraraka Ti Puta. He constantly tears from one eye, and sometimes in the morning there is a little pus in the corner of the eye . The mother is very sad and scared. This is what can be seen in congenital dacryocystitis.

• Acquired Dacryocystitis: This is a condition that develops later in life due to a variety of reasons. For example, it can be caused by fractures, surgery, tumors in the nose or near the eye, or the use of certain medications.

How common is this condition?

According to statistics, about 6% of babies are born with a condition called Congenital Nasolacrimal Duct Obstruction (NLDO) . Dacryocystitis affects about 1 in 3,884 live births. It is more common in girls than boys, because their tear ducts are narrower.

What are the symptoms of dacryocystitis?

If you have dacryocystitis, you may experience one or more of these symptoms:

• Eye pain: Especially on the inside of the eye , near the nose.
• Swelling around the eyes: Swelling occurs in that area.
• Redness or darkening of the skin: The swollen area may become red, perhaps with a slightly blue/purple tint.
• An opening or wound in the inner corner of the eyeball: This can leak pus .
• Fever: There is a possibility of getting a fever due to an infection.

In chronic dacryocystitis, these symptoms may be somewhat less severe. For example, you may still have watery eyes, but the fever may disappear.

What are the causes of dacryocystitis?

As we discussed earlier, the main cause is a blocked tear duct . This blockage prevents tears from flowing from the eyes to the nose.

In newborn babies, the tear duct is blocked by a thin membrane (`membrane`). However, in older children and adults, this blockage can be caused by a variety of factors.

Here are some factors that can contribute to acquired dacryocystitis:

• Aging: This condition is most common among people over 40 years of age.
• Injuries: Fractures, surgeries, etc. to or around the nose.
• Other medical conditions:Immune system problems, other inflammations or infections like sinusitis.
• Having an abnormal shape of the nose.
• Tumors: Lumps that form in the nose, sinuses, or tear ducts.
• Some medications: For example, medications such as `(Timolol)` for high blood pressure, `(Dorzolamide)` and `(Pilocarpine)` for glaucoma, `(Trifluridine)` for antivirals, and treatments for cancer such as `(Fluorouracil)`, `(Docetaxel)` or `(Radioactive Iodine)`.
• Punctal plugs: These small plugs, sometimes placed as a treatment for dry eyes, can cause blockages if not removed.

Is dacryocystitis contagious?

Although dacryocystitis is associated with an infection, it is not usually contagious from one person to another , so it is not something to be too concerned about.

How does a doctor diagnose this? (How is it diagnosed?)

When you go to see a doctor, they will look at your eyes, examine the area around your nose, and ask you about your symptoms and medical history. Often, this information alone will give the doctor an idea of ​​what is going on.

However, you can also do the following tests to confirm further:

• Eye exam.
• The priest presses on the swollen area and looks for pus-like discharge from the small hole (`punctum`) at the corner of the eye .
• If there is pus, a sample is taken and sent to a laboratory for testing (a `culture`). This can help determine exactly what germ is causing the infection.
• A blood sample is taken and tested, especially the number of white blood cells. If these are high, it is a sign of infection. Sometimes blood tests can also help find other underlying conditions.
• A test in which a yellow dye is placed in the eye (`Dye disappearance test`). This dye is checked to see if it disappears quickly as it normally does along the tear duct. If it takes a long time to disappear, there may be a blockage. If this dye is smeared on a cotton ball placed inside the nose, it indicates a ``partial blockage``.
• Imaging tests. Sometimes a CT scan or MRI scan may be done to find out exactly what is causing the blockage.

Additional tests may be needed, especially if your tears are bleeding (`hemolacria`) or if you have vision problems .

How is dacryocystitis treated?

Okay, now let's see what treatments can be done for this.

• If you have acute dacryocystitis caused by a bacterial infection, your doctor willOral antibiotics or intravenous (IV) antibiotics will be prescribed. You may also be given antibiotic ointment or eye drops.

Some commonly prescribed antibiotics are: `(Amoxicillin-clavulanate)`, `(Cephalexin)`, `(Ciprofloxacin)`, `(Clindamycin)`, `(Trimethoprim-Sulfamethoxazole)`.

• Warm compresses and gentle massage of the swollen area can help relieve symptoms.
• You will start feeling better within a few days of starting antibiotics.

Neonatal dacryocystitis , a condition that occurs in young babies, usually resolves on its own within about a year , even if it recurs.

If you have acute dacryocystitis, after antibiotics, your doctor may suggest surgery . This is called a dacryocystorhinostomy (DCR) . The main treatment for chronic dacryocystitis is a DCR. This surgery creates a new path for tears to drain.

What are the possible complications of DCR surgery?

Like any surgery, DCR surgery can sometimes cause minor complications. But don't worry, these are usually minor.

• Excessive bleeding from the surgical site.
• Infection.
• Sinusitis.
• Minor damage to parts of the eyes or nose.

Your doctor will tell you more about this.

Can dacryocystitis be prevented?

In fact, it's difficult for us to do anything special to prevent the development of many types of dacryocystitis. However, it is important to try to avoid infections . For this,

• Develop good hand washing habits.
• Avoid touching your eyes with your hands unnecessarily.
• Minimize going to crowded places and interacting with sick people as much as possible.

These things provide a little protection.

What happens if this situation occurs?

Although some cases of dacryocystitis can resolve on their own, if you or your child have these symptoms, it is best to see a doctor for advice.

If left untreated, this can become an open sore and sometimes cause vision issues . Therefore, it is important to seek treatment quickly.

When should I see a doctor?

If you or your child has any symptoms of dacryocystitis or even the slightest suspicion that you have one,Don't waste time and see a doctor immediately. Quick treatment can help you recover quickly.

What is the difference between Dacryoadenitis and Dacryocystitis?

These two names are somewhat similar, so they can be confusing. Both conditions are eye-related inflammations/infections, but they occur in different places.

• Dacryocystitis: This is an inflammation/infection of the tear duct/lacrimal sac.
• Dacryoadenitis: This is an inflammation/infection of the tear-producing gland (lacrimal gland). This gland is located under the eyelid, on the upper back of the eye .

Simply put, if you feel discomfort around your eyes, especially in the inner corner of your eyes , near the bridge of your nose, or if you feel a lump or swelling, it could be dacryocystitis. If you have this, definitely see a doctor.

Finally, the most important thing (Take-Home Message)

By now you probably understand that dacryocystitis is an infection or inflammation of the tear sac. It can occur in both infants and adults.

• If you have symptoms like pain, swelling, redness, discharge, or frequent tearing inside your eye , pay attention to it.
• If you notice these symptoms, seek medical advice immediately.
• Don't worry, there are good treatments for this. It can be cured with antibiotics and sometimes a minor surgery.
• Simple things like maintaining cleanliness and washing your hands frequently can help protect against infections.

If you have any further questions about this, you can ask your family doctor or an ophthalmologist. Stay healthy!

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