This is infection of the lacrimal sac. It is usually unilateral and secondary to obstruction of the nasolacrimal duct at the entrance to the nose. It is most common in infants or in persons over 40 years of age, especially post-menopausal women.
Acute dacryocystitis usually results from infection by staphylococcus aureus or less frequently, beta hemolytic streptococcus. In chronic dacryocystitis, streptococcus pneumoniae, or more rarely, Candida albicans may be the causative organism.
Uncommonly, the condition follows obstruction of the nasolacrimal duct by Actinomyces israelii (streptothrix) (1). Actinomyces israelii is a cast-forming Gram-positive anaerobe that is difficult to isolate and identify.
Presentation is with epiphora, swelling and redness at the inner canthus of the eye. In the chronic form, a mucocoele is often formed.
Conjunctivitis develops rarely. A corneal ulcer may develop following minor corneal trauma in the presence of pneumococcal dacryocystitis.
Antibiotics such as penicillin are often effective. A mucocoele suggests obstruction in the nasolacrimal duct and requires dacryocystorhinostomy (a procedure to establish communication between the nasal cavity and the lacrimal sac).
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