Tear-Duct Infection (Dacryocystitis)

What Is It?

Dacryocystitis is an infection in the tear ducts of the eye or in the tear sac, also called the lacrimal sac. At the inner corner of each eye are two small tubes or tear ducts. These tear ducts merge into a larger duct on each side of the face, and drain into the nose. At the upper end of the large duct is the lacrimal sac, which fills with tears produced by the lacrimal gland. Periodically, the tears are released from the lacrimal sac into the tear ducts. Because the ducts run from the eye to the nose, tears can drain into the eye or the nose.

Tear-duct infections occur if there is a blockage in the tear ducts that allows bacteria to collect in the ducts or the lacrimal sac. A blockage also can cause excessive tearing from the eye. Blockages typically are caused by:

• A malformation or underdevelopment of the tear ducts
• Trauma to the nose or eyes that damages the ducts, such as a broken nose
• Aging, with gradual enlargement of the facial bones in the region of the nose
• Nasal polyps

Although tear-duct infections can occur at any age, they are most common in infants who commonly have a congenital (inborn) obstruction of the nasolacrimal duct. Infants with this problem have a narrower drainage passageway that will widen with time as they grow. Most children with the disorder outgrow it by the time they are 1 year old. In adults, older people are most likely to get tear-duct infections because their tear ducts become narrowed by continued growth of surrounding bone. The ducts are more rigid and less able to flush out the debris that can cause blockages.

When an infection first occurs, it is said to be acute. If a tear-duct infection is not treated properly, it can last longer and is then said to be chronic.

Symptoms

Typical symptoms of acute tear duct-infection include:

• Pain, redness and swelling of the lower eyelid at the inner corner of the eye
• Excessive tearing
• Pus or discharge from the eye
• Fever

Symptoms of chronic (long-lasting) tear-duct blockage are less severe. Although there may be tearing and perhaps some pus or discharge, usually there is little or no pain, redness or swelling.

Diagnosis

Your physician will examine you for signs of swelling and redness at the corner of the eye, excessive tearing, discharge of pus and fever. Pressing on the lacrimal sac may cause mucus or pus to come out of the ducts near the eye. A sample of the discharge can be collected and tested to determine the type of bacteria causing the infection.