Dacryocystitis is infection of the tear (lacrimal) sac.
The tear sac is a small chamber into which tears drain. The usual cause of dacryocystitis is a blockage of the nasolacrimal duct, which leads from the tear sac into the nose. Dacryocystitis may occur suddenly (acute) or be longstanding (chronic). In acute infection, the area around the tear sac is painful, red, and swollen. The area around the eye may become red and watery and may ooze pus. Slight pressure applied to the tear sac may push thick material through the punctum (the opening at the inner corner of the eyelid near the nose).
Often the infection is mild. Sometimes, the infection is severe and can cause fever. Sometimes a collection of pus (abscess) may form, which can rupture through the skin, creating a passage for drainage.
A doctor bases the diagnosis on the symptoms and examination findings.
An acute infection is usually treated with an antibiotic taken by mouth. If a fever is present or if the infection is severe, antibiotics given by vein may be required. Applying warm compresses to the area several times a day also helps. After the acute infection resolves, doctors recommend that people have surgery to bypass the blockage (dacryocystorhinostomy [DCR]) so that infection does not recur. DCR is also the main treatment for chronic dacryocystitis.
Last full review/revision October 2014 by James Garrity, MD