Dacryocystitis: Causes, symptoms and treatments
Dacryocystitis is a condition that occurs when a blocked tear duct becomes inflamed and infected. The infection can cause pain and swelling around the eyes, as well as eye watering or discharge.
The condition, though not life-threatening, can be painful or irritating. Fortunately, dacryocystitis is easily treatable with antibiotics and, in some cases, surgery.
What is dacryocystitis?
Dacryocystitis is the clinical name for a tear duct infection, or inflammation of the lacrimal sac. The lacrimal sac is located between the corner of the eye and the bridge of the nose, and is responsible for holding and releasing tears.
While “releasing tears” from the eye is most often associated with crying, the lacrimal gland constantly releases small amounts of tears to keep the eye lubricated. Whenever you blink, the tears are spread across the eyes, keeping them clean, moist and healthy.
Attached to the lacrimal sac is the nasolacrimal duct (or tear duct), which works as a channel to drain tears from the eye to the nasal cavity. When the tear duct becomes blocked due to infection, trauma, inflammation or other factors, your tears are unable to drain correctly.
This causes the tears in the lacrimal sac to become backed up and stagnant, allowing bacteria to grow and infection to develop.
Acute dacryocystitis vs. chronic dacryocystitis
Dacryocystitis can be acute or chronic. Which one is determined by the symptoms experienced and how long they last.
Acute dacryocystitis symptoms will develop quickly and be more severe than chronic dacryocystitis. However, symptoms will typically resolve in less than three months, and as little as a few days with antibiotic treatment.
Chronic dacryocystitis symptoms appear gradually and are more mild than in acute cases. In fact, it’s possible for the only symptoms experienced to be eye watering and discharge.
While the symptoms are relatively minor, individuals with chronic dacryocystitis will experience symptoms for a prolonged period of time (several months or years). Surgical treatment may be required.
Dacryocystitis is caused by a blockage in the nasolacrimal duct, which reduces tear flow and leads to bacteria growth and inflammation. Conditions that cause a tear duct blockage include:
Sinus infections, particularly in the maxillary sinuses located beneath your cheeks, near your nose.
Exposure to the same bacteria that causes staph infection or strep.
Abnormal tissue growth or tumors in the nasolacrimal system.
Nasal inflammation or abscess.
Trauma to the affected region, sometimes caused by nasal or sinus surgery such as endonasal or endoscopic procedures.
Dacryocystitis symptoms vary depending on whether your condition is acute or chronic. As mentioned earlier, acute symptoms will appear quickly and may persist for up to three months. These symptoms include:
Pain and redness in the inner corner of the eye
Swelling and, in severe cases, bruising in the inner corner of the eye, near the nose
Symptoms of chronic dacryocystitis are not as severe as acute cases. The most common symptoms observed are excessive tearing and eye discharge. Fever and inflammation are not present in chronic dacryocystitis.
Dacryocystitis is caused by a blockage in the tear duct. Certain characteristics can make an individual more susceptible to developing a blockage and, in turn, dacryocystitis. Risk factors include:
Infancy — Babies can be born with one or more blocked tear ducts due to an underdeveloped tear drainage system or a duct abnormality. For this reason, it’s common for infants to develop dacryocystitis more than once during the first year of life. However, they will likely grow out of the blockage between 9 and 12 months.
Certain medications — Prescription eye drops to treat glaucoma, such as timolol and pilocarpine, or antiviral medications such as trifluridine and idoxuridine, have been known to increase the chance of tear duct infections.
Being a woman — Females have tear ducts that are more narrow than in males, making them more susceptible to having the ducts obstructed.
Being over age 40 — Punctual openings, which drain tears, narrow as you get older. This slows the draining process for tears and raises the risk of obstruction.
Abnormal nasal structure — Conditions like nasal septum deviation, rhinitis (swelling of the nasal mucous membranes), or turbinate hypertrophy (inflammation of the air filter/humidifier inside the nose) can raise one’s risk of a blockage.
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Treatment for acute dacryocystitis mainly consists of antibiotics, which kill the infection-causing bacteria. Antibiotics can be administered orally with a pill, topically with an ointment or, in severe cases, intravenously (through an IV). Symptoms should resolve fairly quickly once antibiotic treatment begins.
In order to relieve swelling or pain associated with acute dacryocystitis, apply a clean, warm compress (a washcloth will work) on the affected area for 10 to 15 minutes. You can do this several times a day.
Over-the-counter pain relievers can also be used to manage pain or fever associated with dacryocystitis until the antibiotics begin to work.
Individuals with chronic dacryocystitis may be prescribed steroid eye drops. The drops work by reducing inflammation and swelling that can cause the tear ducts to narrow.
Surgery to widen the tear ducts may be necessary for chronic dacryocystitis sufferers. The procedure, called dacryocystorhinostomy, uses a laser to remove pieces of bone surrounding the tear duct. This widens the duct passageways and removes any blockages.
When to see a doctor
While it’s possible for acute dacryocystitis to resolve on its own without proper treatment, it’s recommended that you see an eye doctor for dacryocystitis symptoms. Acute dacryocystitis that goes untreated can develop into chronic dacryocystitis.
In rare cases — specifically in babies — the infection could spread to the eye socket, leading to orbital cellulitis, meningitis or a brain abscess.
If you or your child are showing dacryocystitis symptoms, it’s better to err on the side of caution and see an eye doctor. They will be able to assess symptoms, make an official diagnosis and establish the best method of treatment for a quick recovery.
RELATED READING: Common eye infections
Page published in January 2021
Page updated in May 2021