Dacryocystitis is inflammation of the lacrimal sac which typically occurs secondarily to obstruction within the nasolacrimal duct and the resultant backup and stagnation of tears within the lacrimal sac.
Dacryocystitis is caused by obstruction at any level of the
nasolacrimal duct which leads to stagnation of tears in a pathologically closed lacrimal drainage system, with the stagnated tears providing a favorable environment for infectious organisms. The lacrimal sac will then become inflamed leading to the characteristic erythema and edema at the inferomedial portion of the orbit.
First, acute dacryocystitis should be addressed, using oral antibiotics with gram positive coverage. Warm compresses and massages. The patients who fail conservative treatment often undergo lacrimal probing, which is successful in 70% of cases. In still unsuccessful, surgical interventions are needed, such as stenting, balloon dacryoplasty, and dacryocystorhinostomy (can be done percutaneously as an external procedure or endoscopically).