O OftalmopediaAn open ophthalmology reference ⌕

Dacryocystocele

AI overview

Dacryocystocele is a benign, bluish-gray mass in the inferomedial canthus that develops within a few days or weeks after birth, caused by narrowing or obstruction of the nasolacrimal duct.

Key points
  • It forms as a result of narrowing or obstruction of the nasolacrimal duct, usually during prenatal development.
    source quote
    forms as a result as a consequence of narrowing or obstruction of the nasolacrimal duct , usually during prenatal development
  • The cyst location can cause respiratory dysfunction by compromising the airway.
    source quote
    The location of the cyst can cause respiratory dysfunction, compromising the airway.
  • The obstruction leads to epiphora, an abundance of tear production.
    source quote
    The obstruction ultimately leads to epiphora , an abundance of tear production.
  • There are three types: acute, congenital, and chronic.
    source quote
    There are three types of dacryocystocele: acute, congenital and chronic.
  • The population most affected are infants.
    source quote
    the population most affected by this rare condition are infants
Symptoms
  • Common symptoms include pain surrounding the outer corner of the eye.
    source quote
    Pain surrounding the outer corner of the eye and areas around.
  • Redness is a common symptom.
    source quote
    Redness
  • Swelling of the eyelid occurs.
    source quote
    Swelling of the eyelid
  • Reoccurring conjunctivitis may occur.
    source quote
    Reoccurring conjunctivitis
  • Epiphora (overproduction of tears) is a symptom.
    source quote
    Epiphora (overproduction of tears)
  • Pus or discharge may be present.
    source quote
    Pus or discharge
  • Fever can occur, particularly in acute cases.
    source quote
    Fever
  • Acute dacryocystocele includes fever and pus from the eye region.
    source quote
    Acute dacryocystocele is a bacterial infection, that includes symptoms such as fever and pus from the eye region.
  • Chronic form causes pain or discomfort from the corner of the eye.
    source quote
    People with the chronic form of the condition experience symptoms of pain or discomfort from the corner of the eye.
  • Congenital form in infants may present with watering or discharge from the eyes.
    source quote
    The infant may have watering or discharge from the eyes.
Diagnosis
  • Diagnosis can be made prenatally using routine obstetric ultrasound.
    source quote
    The diagnosis can be made prenatally; routine obstetric ultrasound can identify the characteristic hypoechoic lesion inferior and medial to the globe.
  • It is important to distinguish from encephalocele, a more serious neural tube defect.
    source quote
    It is important to distinguish a dacrocystocele from the more serious encephalocele , which is a neural tube defect
  • Postpartum diagnosis can be made with non-invasive ultrasound.
    source quote
    A dacryocystocele can be diagnosed postpartum with a non-invasive ultrasound (US).
  • Examination of discharge from the eye is used.
    source quote
    Examination of discharge from the eye
  • Blood culture is among the diagnostic tests.
    source quote
    Blood culture
  • X-ray can help diagnose skeletal abnormality.
    source quote
    X-ray (can help diagnose skeletal abnormality)
  • CT Scan is useful in suspected cases of mass.
    source quote
    CT Scan (useful in suspected cases of mass)
  • Dacryocystography (DCG) is a diagnostic test.
    source quote
    Dacryocystography (DCG)
  • Nasal endoscopy is used for diagnosis.
    source quote
    Nasal endoscopy
  • Dye disappearance test indicates if there is blockage in the eye.
    source quote
    Dye disappearance test: indicates if there is blockage in the eye
Treatment
  • A warm compress is placed on the affected area to help open up the ducts.
    source quote
    To relieve dacryocystocele symptoms, a warm compress is placed on the affected area to help open up the ducts.
  • Over the counter anti-inflammatory and pain relievers are recommended to reduce fever and pain.
    source quote
    Taking over the counter medication, such as anti-inflammatory and pain relievers are recommended in order to reduce fever and pain symptoms.
  • Oral antibiotics are used to resolve the infection.
    source quote
    Since dacryocystocele is an infection of the tear sacs, the condition is resolved by taking oral antibiotics.
  • Acute dacryocystocele may spontaneously resolve or with pressure directed toward the nose.
    source quote
    With acute dacryocystocele the mass may spontaneously resolve or with pressure directed toward the nose.
  • Chronic dacryocystocele may require nasolacrimal duct probing to open the obstruction.
    source quote
    with chronic dacryocystocele, the nasolacrimal duct probing may be required to open the obstruction.
  • Surgery called dacryocystorhinostomy uses laser to remove bone structure on the nose to widen the tear duct.
    source quote
    The procedure for the surgery is called dacryocystorhinostomy , laser is used to remove some of the bone structure on the nose in order to widen the tear duct.
Red flags
  • If untreated, can lead to meningitis.
    source quote
    Meningitis
  • If untreated, can lead to sepsis.
    source quote
    Sepsis
  • If untreated, can lead to orbital cellulitis.
    source quote
    Orbital cellulitis
  • If untreated, can lead to sinusitis.
    source quote
    Sinusitis
  • If untreated, can lead to brain abscess.
    source quote
    Brain abscess
Prognosis

Recovery for acute dacryocystocele is a couple of days to 2 weeks with antibiotics; chronic recovery varies and depends on surgery. Surgery success rate is 93%-97%, with recovery taking 3-6 months. Mortality and morbidity rates are significantly low, and early treatment yields a high success rate, particularly in infants.

AI-synthesized from the Wikipedia article “Dacryocystocele”. Not medical advice. Verify source →
Dacryocystocele
Nasolacrimal duct
SpecialtyNeurology 

Dacryocystocele (Dacryocystitis) or timo cyst is a benign, bluish-gray mass in the inferomedial canthus that develops within a few days or weeks after birth. The uncommon condition forms as a result as a consequence of narrowing or obstruction of the nasolacrimal duct, usually during prenatal development. Nasolacrimal duct obstruction disrupts the lacrimal drainage system, eventually creating a swelling cyst in the lacrimal sac area by the nasal cavity. The location of the cyst can cause respiratory dysfunction, compromising the airway. The obstruction ultimately leads to epiphora, an abundance of tear production.[1]

Dacryocystocele is a condition that can occur to all, at any age. However, the population most affected by this rare condition are infants. The intensity of the symptoms may vary depending on the type of dacryocystocele. There are three types of dacryocystocele: acute, congenital and chronic. Acute dacryocystocele is a bacterial infection, that includes symptoms such as fever and pus from the eye region. While, chronic dacryocystocele is less severe. People with the chronic form of the condition experience symptoms of pain or discomfort from the corner of the eye. Congenital is the dacryocystocele form that appears in infants. The infant may have watering or discharge from the eyes.[1]

Common symptoms of all types of dacryocystocele include:

  • Pain surrounding the outer corner of the eye and areas around.
  • Redness
  • Swelling of the eyelid
  • Reoccurring conjunctivitis
  • Epiphora (overproduction of tears)
  • Pus or discharge
  • Fever

Complications

If the infection is not treated early in the course of the condition, dacryocystocele can lead to life-threatening illnesses: [2]

The nasolacrimal ducts drain the excess tears from our eyes into the nasal cavity. In dacryocystocele this tube gets blocked on either end and as a result when mucoid fluid collects in the intermediate patent section it forms a cystic structure.

The infection is often caused by:

  • injury to eye or nose area
  • nasal abscess
  • abnormal mass inside of the nose
  • inflammation
  • surgery (nasal or sinus)
  • cancer
  • sinusitis

The nasolacrimal system is located within the maxillary bone. The purpose of the nasolacrimal ducts is to drain tears from the eye area of the lacrimal sac and eventually through the nasal cavity. Dacryocystocele is caused by blockage on the nasolacrimal duct, as a result when mucoid fluid collects in the intermediate patent section it forms a cystic structure. The cyst is formed by the eye and nose region. A blockage of epiphora can become an area for infections to take over. Once an infection occurs, the lacrimal sac will inflame causing swelling and the cystic formation.

The diagnosis can be made prenatally; routine obstetric ultrasound can identify the characteristic hypoechoic lesion inferior and medial to the globe. It is important to distinguish a dacrocystocele from the more serious encephalocele, which is a neural tube defect.

A dacryocystocele can be diagnosed postpartum with a non-invasive ultrasound (US).

Among the adult population, several tests can be ordered to further diagnose the condition. Initially, a physician would use a patient's medical history or any visible symptoms that can indicate of having the condition. Tests that are used to diagnose a patient include:[1]

  • Examination of discharge from the eye
  • Blood culture
  • X-ray (can help diagnose skeletal abnormality)
  • CT Scan (useful in suspected cases of mass)
  • Dacryocystography (DCG)
  • Nasal endoscopy
  • Dye disappearance test: indicates if there is blockage in the eye

To relieve dacryocystocele symptoms, a warm compress is placed on the affected area to help open up the ducts. Taking over the counter medication, such as anti-inflammatory and pain relievers are recommended in order to reduce fever and pain symptoms.[citation needed]

Since dacryocystocele is an infection of the tear sacs, the condition is resolved by taking oral antibiotics. With acute dacryocystocele the mass may spontaneously resolve or with pressure directed toward the nose. With time the cyst will outgrow the blockage. However, with chronic dacryocystocele, the nasolacrimal duct probing may be required to open the obstruction. Surgery may be needed to widen the tear ducts in order to reduce the blockage occurring in the eye area. The procedure for the surgery is called dacryocystorhinostomy, laser is used to remove some of the bone structure on the nose in order to widen the tear duct.[citation needed]

Recovery for acute dacryocystocele would be a couple of days to 2 weeks, with the help of antibiotics. However, with chronic dacryocystocele recovery time varies. This recovery time all depends if the person with chronic dacryocystocele receives surgery for the condition. Recovery time for the surgery (specifically DCR), is between three and six months. The success rate of the surgery is 93%- 97%.

Mortality and morbidity rates with this condition are significantly low. This condition can have a high success rate if treated early, particularly among infants with congenital dacryocystocele.[3]

Dacryocystocele is most prominent among infants, the prevalence is 1 in 3884 live births.[3]

90% of the infants with the condition recover by the time they turn a year old. Among the adult population, those 40 years old and older are more likely to develop the condition, especially women. 75% percent of dacryocystocele cases in adult are from women.[3] Women have narrower nasal ducts than men, and are more prone to develop the condition.

Dacryocystocele becomes more prevalent among people with the following pre-existing conditions:

In 2018, a research study was conducted in Northwest Iran among patients with dacryocystocele. The purpose of the research experiment was to examine bacterial and antibiotic susceptibility among the group with the condition. A total of 129 patients with dacryocystitis participated in the study. Patients under the age of eighteen needed written consent for participation. All patients that were referred to the clinic of ophthalmology were selected to participate, exclusion for participation was taken into consideration if the patient had previous treatment with antibiotics.

In order to go forward with the study, nasolacrimal duct discharges were injected into growth medium to isolate and determine microbial agent stains present in the discharges. To test the antibiotic susceptibility among dacryocystocele patients a disc diffusion method was utilize.

From the 129 patients that participated in the experiment, 83 were female and 46 were male patients. Results from the culture sample demonstrated that S. aureus, S. epidermidis, and S. pneumonaie were the most common strains of microorganisms among patients with actue dacryocystitis. However, patients with chronic dacryocystitis, they demonstrated prevalence among the S. epidermidis, Pseudomonas spp., S aureus, and C. albicans strains.

Results from the antibiotic susceptibility tests demonstrated that patients in the Northwest region of Iran were most sensitive to the following antibiotics: ciprofloxacin, ceftriaxone, vancomycin, chloramphenicol, gentamicin, and erythromycin. It is concluded that ciprofloxacin and vancomycin are the most effective medications among the patients with the condition in the region of Iran. This study was beneficial to determine which medications worked best to treat the people of Northwest Iran more adequately. Other regions around the world should take consideration of this study in order to treat dacryocystocele effectively in their regions.[4]

  1. 1 2 3 "Dacryocystitis : Symptoms, Diagnosis and Management". AIMU. 28 February 2017.
  2. ↑ "Dacryocystitis". The Lecturio Medical Concept Library. 7 October 2020. Retrieved 11 July 2021.
  3. 1 2 3 Taylor, Roger S.; Ashurst, John V. (26 June 2020). "Dacryocystitis". StatPearls. StatPearls Publishing. PMID 29261989.
  4. ↑ Eslami, Fatemeh; Basir, Hamid Reza Ghasemi; Moradi, Abbas; Farah, Shokoufe Heidari (25 September 2018). "Microbiological study of dacryocystitis in northwest of Iran". Clinical Ophthalmology. 12: 1859–1864. doi:10.2147/OPTH.S175463. PMC 6165732. PMID 30310264.