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what is chronic Dacryocystits?

Definition:- It is an inflammation of Lacrimal sac due to the chronic obstruction of Nasolacrimal duct(NLD). 
Causes:- the main cause of chronic Dacryocystits is obstruction of NLD.
Causes of NLD obstruction:-
1. Foreign bodies
2. Stagnation of tears in tear sac
3. Recurrent conjunctivitis may block NLD by        epithelial debris and mucous plug. 
4. Nasal polyp 
5. Deviated nasal septum(DNS) 
6. Tumour
7. Infection (streptococcus, staphylococcus,          pneumococcus) 
Clinical features (C/F):- clinical features of Chronic Dacryocystits may be divided 4 stages. 
1. Stage of chronic Cattarhal Dacryocystits
2. Stage of Lacrimal Mucocele
3. Stage of chronic Suppurative Dacryocystits
4. Stage of chronic Fibrotic Sac

1. Stage of chronic Cattarhal Dacryocystits:-
    a. Watery eyes
    b. Regurgitation test:- clear or mucoid fluid            discharge from lower puncta
    c. Dacryocystography:- reveals blockage of            NLD

2. Stage of Lacrimal Mucocele:- 
    a. Constant epiphora
    b. Regurgitation test:- milky or mucoid fluid            discharge from lower puncta. 
    c. Dacryocystography:- reveals blockage of            NLD
    d. Encysted Mucocele:- if opening of                        Canaliculi blocked.

3. Stage of chronic Suppurative Dacryocystits:-
    a. Epiphora
    c. Recurrent conjunctivitis Amd swelling at            inner canthus
    c. Regurgitation test:- purulent discharge                from lower puncta
    d. Encysted Pyocele:-  if opening of both                Canaliculi blocked.

4. Stage of chronic Fibrotic Sac:- 
     a. Low grade repeated infection causes small fibrotic sac. 
     b. Dacryocystography:- Reveals very small sac with irregular folds in the mucosa. 

Complications:-
1. Conjunctivitis
2. Acute or chronic Dacryocystits
3. Corneal ulceration

Treatment:-
1. Conservative treatment:- Syringing and              probing
2. Ballon catheter dilation
3. Dacryocystorhinostomy(DCR) Operation of        choice
4. Dacryocystectomy(DCT) 


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