Acute dacryocystitis

Definition, types, clinical features and complications

1. ACUTE DACRYOCYSTITIS NR AISHWARYA MBBS PIMS

2. Acute dacryocystitis is an acute suppurative inflammation of the lacrimal sac , characterized by presence of swelling in the region of sac The term derives from the greek dakryon (tear), cysta (sac),and it is(inflammation) The onset is acute ,and there is painful swelling below the inner canthus ,often combined with cellulitis DEFINITION

3. Obstruction of nasolacrimal duct leads to stasis of nasolacrimal fluid-infection Staphylococcus aureus –most common Pneumococcus Causative organism

4. 3 Stages Stage of cellulitis Stage of lacrimal abscess Stage of fistula formation Risk factor Age-more common between 40-60 years( lacrimal drainage system loses its elasticity) Poor personal hygiene STAGES OF DACRYOCYSTITIS

5. Characterized by a painful swelling in the region of lacrimal sac Associated with epiphora,fever and malaise Swelling is red,hot,firm and tender Redness and edema spread to the lips and cheek When treated resolution may occur Stage of cellulitis

6. Continous inflammation causes occlution of the canaliculi due to oedema The space is filled with pus,distends and its anterior wall ruptures forming a pericystic swelling -large lacrimal abscess formed Points below and outer side of the sac-due to gravitation of pus & medial palpebral ligament in the upper part. Stage of lacrimal abscess

7. MEDIAL PALPEBRAL LIGAMENT

8. Lacrimal abscess

9. When lacrimal abscess is left unattended-discharge spontaneously- external fistula below medial palpebral ligament Rarely, abscess may opens into the nasal cavity- internal fistula Stage of fistula formation

10. External fistula

11. Acute conjuntivities Corneal abrasion which may converted into corneal ulcer Lid abscess Osteomyelitis of lacrimal bone Orbital cellulitis Facial cellulitis Rarely cavernous sinus thrombosis can occur COMPLICATIONS