What is the role of obstruction in the etiology of dacryocystitis?

Updated: Oct 08, 2019
  • Author: Grant D Gilliland, MD; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

In acquired dacryocystitis, obstruction of the lower part of the nasolacrimal system frequently is present. Because of the intimate relationship of the nasolacrimal duct with the nose and paranasal sinuses, these structures are commonly associated as an etiologic factor in the pathogenesis of dacryocystitis.

One of the more common associations, if not a factor in the etiology of dacryocystitis, is ethmoidal inflammation. Because only a very thin lamina of bone is present between the ethmoid air cells and the lacrimal sac, it is not uncommon for inflammation of the ethmoid sinuses to cause dacryocystitis.

An ocular origin for inflammation of the lacrimal system is less common than a nasal origin.

Several cases of obstruction of the nasolacrimal duct by impacted cilia have been described.

Profuse secretion and stagnation of tears in the lacrimal sac, which may occur in uncorrected astigmatism and hypermetropia, may contribute to the development of dacryocystitis.

Most cases of dacryocystitis in adults are caused by stenosis of the lacrimal duct with resultant stagnation of lacrimal fluid and subsequent infection.


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