Lacrimal Infections


  • Symptoms include pain, tenderness and swelling of {the} lateral aspect of {the} eyelid
  • May occur with systemic diseases such as Sjogren's, sarcoidosis, syphilis, TB, lymphoma, and benign lymphoid hyperplasia
  • May occur in patients with mums, EBV, zoster


  • Symptoms include pain, swelling, tenderness of {the} INNER canthus of {the} eye
  • Etiology is usually actinomycetes
  • May be treated with Penicillin irrigation
  • Actinomycetes is also sensitive to gtts 


  • Symptoms: acute onset, tearing (from nasolacrimal duct obstruction), redness, purulent discharge, tender swollen lacrimal sac
  • An infection within {the} "tear duct" causes a painful swelling in {the} inner corner of {the} eyelids.
  • If {the} tearing causes severe symptoms, surgery can be performed to create a new tear duct. This operation is called "dacryocystorhinostomy." (see below). Small silicone tubes my be placed in {the} tear system to keep {the} new tear duct open while healing occurs. Surgical elimination of {the} obstruction by creating a new tear duct is necessary to eliminate {the} tearing and infection that can result from such a blockage

Acute Dacryocystitis

  • various etiologies, all cause nasolacrimal duct obstruction with obstruction of drainage from lacrimal sac to nose
    • chronic tear stasis causes 2o infxn
    • edema, erythema below medial canthal tendon w/lac sac distention
    • +/- pain
    • rule out ethmoidal sinusitis, don't probe
  • Treatment
    • warm compresses
    • oral/IV abx (Keflex, Augmentin), topical only limited value
    • Incision Drainage localized abscess
  • Complications
    • mucocele, chronic conjunctivitis, orbital cellulitis
    • most need DCR after acute infection subsides

Chronic Dacryocystitis

  • distended lac sac with minimal inflammation suppurative discharge from punctum c/w nasolacrimal duct obstruction
  • probe/irrigate upper system only
  • dacryoliths from Actinomyces, Candida, topical meds, can cause lacrimal colic if impacted in NLD
  • Treatment
    • usually needs DCR for resolution
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