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miebomitis, blepharitis and canaliculitis. Points that differentiate and favour
bacterial conjunctivitis included sudden onset redness with discharge and
diffuse conjunctival congestion. Pre-septal cellulitis is an acute inflammation
involving the eyelid, not associated with discharge or long standing epiphora.
Meibomitis and blepharitis are usually bilateral associated with irritation of the lid
margins and burning sensation. Canaliculitis can be differentiated by focal swelling
of the canalicular portion of the eyelid margin with pouting puncta and inspissated
discharge.
IV. PREVENTION AND COUNSELING
There are no known preventive measures for chronic dacryocystitis. Infections and
inflammations are the major known causes for it. Therefore a good hygiene can at
least prevent secondary infections of the lacrimal sac from the conjunctiva and nasal
mucosa.
V. OPTIMAL DIAGNOSTIC CRITERIA, INVESTIGATIONS,
TREATMENT & REFERRAL CRITERIA
*Situation 1: At Secondary Hospital/ Non-Metro situation: Optimal
Standards of Treatment in Situations where technology and
resources are limited
a) Clinical Diagnosis:
History taking, comprehensive evaluation of the eye and understanding of the
general epidemic prevalence of this condition in the society is crucial to establish a
diagnosis . Patients usually come with typical history of chronic watering, matting of
eye lashes on waking, discharge and redness of the eye.
Examination: The ocular examination includes recording visual acuity, an external
eye examination and slit-lamp biomicroscopy.
Visual acuity measurement: Although visual acuity is normal in patients with
dacryocystitis, discharge sliding across the eye may cause visual disturbances.
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