Tear Duct Infection

What is Tear Duct Infection?

Tear duct infection is a very common eye infection that affects the lacrimal sac/tear sac. It may obstruct the drainage system of the eye partially or completely. Other names are Dacryocystitis and Nasolacrimal duct obstruction (NLDO).

Acute Dacryocystitis

Acute Dacryocystitis is a condition when tear duct infection persists for a prolonged duration. This stage of infection occurs due to lack of proper treatment on time. This can give rise to other symptoms lasting for an extended period which is known as Chronic Dacryocystitis.

Tear Duct Infection in Infants

Commonly prevalent in infants when the constricted drainage passage gradually gets widened and open in most cases. By applying home remedies (like massage,), it is curable. The blockage of the Nasolacrimal duct in babies is congenital. Adults may also suffer, but only due to unusual narrow passage developed by the growth of adjacent bone.

Causes

  • Nasal or sinus infection
  • Chronic nasal infection
  • Injury to the eyes
  • Congenital blocked tear duct
  • Long-term use of medication (such as the use of eye drops to treat glaucoma)
  • Nasal polyps
  • Any obstruction near the nose
  • Nasal diseases like rhinitis and deviated nasal septum
  • Infection due to the bacterium where the causing agents in adults include Staphylococcus epidermis, Staphylococcus aureus, Pneumococcus, Fusobacterium and Pseudomonas aeruginosa. In children, they include Beta-haemolytic streptococcus, Haemophilus influenza, pneumococcus, and Staphylococcus aureus.

Symptoms

  • Excessive tearing
  • Watery eyes
  • Redness and swelling of the lower eyelid
  • Irritation and swelling in the corner of the eye
  • Pus or mucus discharge from the eye
  • Fever
  • Pain near inside the corner of the eye
  • Crusting of the eyelids
  • Blurred vision
  • Inflamed tear ducts

Diagnosis

  • Irrigation probing method: Doctor instills a saline solution through the tear duct to check whether the eye’s drainage system is working efficiently or not. He/she inserts a delicate equipment in the tear duct through the corner of the eyelid (puncta) to probe the duct’s internal condition.
  • Tear drainage test: A single drop of special dye is placed on the surface of each eye. If it washes away or disappears, there is no problem with the duct. However, if some amount of dye remains on the surface, it means one has an infection or blockage. This test analyzes the quick flow of tears/drainage.
  • Eye imaging technique: A dye passes through the tear duct and with the help of X-ray, Computerized Tomography (CT) Scan and Magnetic Resonance Imaging (MRI) images are captured. These images then go through medical analysis that helps in tracing the location of and reason for the blockage or infection.
  • Physical examination: The procedure involves examining the redness, excessive tears and swelling of the eyes. Doctors press the lacrimal sac to observe if any mucus, pus or another kind of discharge is coming out. If there is any discharge, it gets collected as a sample for lab tests.

Treatment

  • Medications: Antibiotic eyedrops or pills are the most preferred and effective medicines to fight the infection.
  • Dilation and probing: An eye specialist opens up the puncta with special dilation instrument. After that, he inserts a slender probe into the tear duct which then flushed to clear the obstructions. This process is carried out under anesthesia in case of infants.
  • Massage: An incomplete opening of tear duct’s tissue membrane in infants causes nasolacrimal duct obstruction. To open that concerned membrane, doctors suggest different methods of massage.
  • Surgery:  To treat the blocked tear duct, Dacryocystorhinostomy is the most common surgery. In external surgery, the surgeon makes a small incision near lacrimal sac. Then connects it to the nasal cavity and places a temporary splint inside it. On the other hand, in the endoscopic or endonasal method, a surgeon uses the microscopic camera along with a thin instrument to go through the tear
  • Balloon catheter dilation: Doctor Threads a tube (catheter) with a deflated balloon on the tip of the nose tear duct, and the patient inflates and deflates the balloon. As a result, duct gets unblocked.

Prognosis

In the context of tear duct infection better outcome rate is high. Proper treatment and medical attention on a regular basis are very important. Recovery period in infants is about a year, while in adults, it takes a couple of months. Sometimes the prognosis depends on the severity of the infection. Early diagnosis and treatment ensures a faster recovery and excellent outcome.

References

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