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Rhinosinusitis and Lacrimal Disorders
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Dacryocystocoele is a congenital swelling at medial canthus due to trapped fluid inside the lacrimal sac and nasolacrimal duct. It is tense, blue, and not pulsatile. MRI is helpful in excluding other pathology.Surgery is reserved if there is lack of spontaneous improvement in 2 weeks or the patient develops acute dacryocystitis or respiratory difficulties.
Watery Eyes
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Dacryocystitis: If you suspect nasolacrimal obstruction, then an acute infection such as a dacryocystitis needs to be excluded. Treatment of dacryocystitis involves oral co-amoxiclav 625 mg TDS, G. chloramphenicol QDS, warm compress and massage of the lacrimal sac to encourage expression of the pus from the sac. Mark the area of cellulitis (or take photographs) as they need to be reviewed in 24–48 hours to ensure cellulitis is not worsening, but is beginning to improve. Consider admission and IV antibiotics with cases of severe cellulitis. If dacryocystitis is present but the abscess is not ‘pointing’ it is prudent to leave things be; only incise an abscess if it was going to burst spontaneously.
Ophthalmology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Clinical presentation: lacrimal massage usually improves the situation but occasionally probing under general anaesthetic is needed. Very rarely, the lacrimal sac becomes expanded due to the distal blockage and the child presents with a dacryocoele (Fig. 7.15). If this becomes infected it is termed a dacryocystitis.
Multi-resistant Enterobacter cloacae dacryocystitis and preseptal cellulitis: case and review of literature
Published in Orbit, 2023
Michael Kvopka, Ezekiel Kingston, Daniel D.H. Nguyen, Jessica Y. Tong, Hayden L. Kirk, Claudia M. Whyte, James D. Dalgliesh, Jennifer J. Danks
Dacryocystitis involves inflammation of the lacrimal sac, often secondary to obstruction of the nasolacrimal duct.1 Acquired dacryocystitis is an uncommon presentation which is most frequently found in Caucasian females over the age of 40 years.2 Pathogens frequently responsible for acute dacryocystitis include Staphylococcus aureus, Pseudomonas spp., and Streptococcus pneumoniae.1 To the authors’ knowledge, this is the first reported case of concurrent dacryocystitis and preseptal cellulitis secondary to Enterobacter cloacae (E. cloacae). It is also the first case of E. cloacae dacryocystitis which failed to respond to chloramphenicol, amoxicillin, and third generation cephalosporins. Our experience is a pertinent reminder of the ever-growing threat of multi-resistant bacteria that must be considered when treating infections such as dacryocystitis. Multidisciplinary input from infectious diseases specialists is often warranted. This report adhered to the ethical principles outlined in the Declaration of Helsinki as amended in 2013.
The effectiveness of the dacryocystorhinostomy operation with physiodispenser in nasolacrimal duct obstruction
Published in Orbit, 2022
Fikret Ucar, Servet Cetinkaya, Lutfi Seyrek
Nasolacrimal duct obstructions are characterized by epiphora, mucopurulent secretions, photophobia, lid edema, swelling, and edema in the sac localization, and recurrent acute dacryocystitis attacks.1 The disease has acute and chronic forms. Surgical treatment is required for chronic dacryocystitis. A persistent passage is formed between the lacrimal sac and the nasal cavity.2 External dacryocystorhinostomy (DCR) is accepted as the gold standard. It was first introduced by Toti in 1904. Dupuy-Dutemps and Bourguet performed anastomosis between the lacrimal sac and nasal mucosa in 1921.3 The causes of failure of this surgery were insufficient bone ostium, closure of anastomosis between the lacrimal sac and nasal mucosa, common canalicular obstruction, adherence and granulation tissue formation at the anastomosis line, and scar formation between the anterior and posterior flaps. A successful DCR contains an ostium with a permanent mucosal layer. The success rate is generally 95% for the DCR types.4–9 A sufficiently sized bony ostium and the continuity of the mucosal layer are the main factors that contribute to a successful surgery. If the anastomosis between the lacrimal sac and nasal cavity is designed as a physiological trough, it will protect the attacks of granulation tissues produced by the healing process.
Lacrimal Fossa Bony Changes in Chronic Primary Acquired Nasolacrimal Duct Obstruction and Acute Dacryocystitis
Published in Current Eye Research, 2021
Mohammad Javed Ali, Dilip Kumar Mishra, Nandini Bothra
Institutional review board and Ethics committee approval of the L.V. Prasad Eye Institute was obtained. The study was conducted in accordance with the Declaration of Helsinki. A Prospective study was performed on 25 bony lacrimal fossae (LF) of 25 eyes of 15 patients who underwent endoscopic dacryocystorhinostomy at a tertiary care Dacryology service over a period of 6 months. Chronic PANDO was defined as a symptomatic disease duration of more than a year. Ten patients with chronic PANDO with bilateral involvement (Chronic group) and five patients of unilateral acute dacryocystitis (Acute group) were recruited in the study. Of these five patients, two were acute dacryocystitis in patients with pre-existing chronic PANDO. For the remaining three patients, acute dacryocystitis was their first symptom. All the patients of acute dacryocystitis were operated in an acute stage by an endoscopic DCR, as there is an increasing evidence of the benefits in doing so.6 None of the patients had a history of trauma or previous surgeries or nasal disease in the past.