What are the signs and symptoms of dacryocystitis?

Updated: Oct 08, 2019
  • Author: Grant D Gilliland, MD; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Acute dacryocystitis is manifested by the sudden onset of pain, erythema, and edema overlying the lacrimal sac region. [7]

The tenderness is characteristically localized in the medial canthal region but may extend to the nose, cheek, teeth, and face.

Thermography has demonstrated an intensive hemifacial reaction in patients with acute dacryocystitis. Frequently, a purulent discharge is noted from the puncta.

It is not uncommon for the sac to rupture and fistulize through the skin; this fistula commonly closes after a few days of drainage.

Conjunctival injection and preseptal cellulitis often occur in conjunction with acute dacryocystitis.

Epiphora is invariably present, and it is not uncommon for a palpable mass to be noted inferior to the medial canthal tendon.

A few patients present with fever, prostration, and an elevated leukocyte count.

More serious sequelae of acute dacryocystitis include extension into the orbit with formation of an abscess and development of orbital cellulitis. When this occurs, it may lead to blindness, cavernous sinus thrombosis, and death.

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