Page 122 - NAME OF CONDITION: REFRACTIVE ERRORS

NAME OF CONDITION: CHRONIC DACRYOCYSTITIS

I. WHEN TO SUSPECT/ RECOGNIZE?

a) Introduction:

Chronic dacryocystitis is an inflammatory condition of the lacrimal sac most
commonly associated with partial or complete obstruction of the nasolacrimal duct .
Most chronic dacryocystitis present with watering and discharge, but some may

progress and cause severe ocular and extra ocular complication. Even in mild
conditions, it may cause a significant ocular morbidity and loss of work place
efficiency because watering can blur the vision momentarily, prevent a person from
concentrating on some work and can be socially embarrassing. It affects all ages and
all social strata but women are more likely to develop dacryocystitis because of their
nasolacrimal ducts are anatomically narrower as compared to males. Approximately
3% of all the ophthalmic clinical visits and 1% of all emergency room visits are
related to dacryocystitis. The underlying etiology, typical infectious organisms and
preferred treatments are important issues to understand in the management of this
common disorder.

b) Case definition:

Dacryocystitis is defined as inflammation of the lacrimal sac. The sac is a part of the
lacrimal excretory system whose function is to transport the tears from the eyes to
the nose.

II. INCIDENCE OF THE CONDITION IN OUR COUNTRY

Chronic dacryocystitis is a common ophthalmic problem. Although there are no

reliable figures that document the incidence or prevalence of chronic dacryocystitis,
large studies from the west have documented it to be around 3% of all the clinical
ophthalmic visits. Since the lacrimal system is prone to infections as it is contiguous
with both conjunctiva and nasal mucosa, dacryocystitis is considered much more
common in developing countries like India. The morbidity is much more than
expected because of its chronic nature, social factors as discussed already, tendency
for acute painful exacerbations and its complications.

III. DIFFERENTIAL DIAGNOSIS

Although chronic dacryocystitis is not very difficult to diagnose, there could still be
certain atypical cases which may masquerade in a similar fashion and needs to be
kept in mind. They include bacterial conjunctivitis, pre-septal cellulitis,

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