Dacryocystocele

Dacryocystocele

Illustration of a dacryocystocele

A dacryocystocele is a rare condition that affects the lacrimal system, specifically the lacrimal sac. It is characterized by the dilation and obstruction of the lacrimal sac, leading to the accumulation of tears and mucus. This condition primarily affects infants, although it can also occur in adults.

Symptoms

The most common symptom of a dacryocystocele is a bluish swelling in the inner corner of the eye, known as the lacrimal sac. This swelling is often accompanied by excessive tearing, discharge, and redness of the affected eye. In some cases, the dacryocystocele may become infected, leading to additional symptoms such as fever and pain.

Causes

Dacryocystoceles are typically caused by a blockage in the nasolacrimal duct, which is responsible for draining tears from the eye into the nasal cavity. This blockage can be congenital, meaning it is present at birth, or it can develop later in life due to trauma, infection, or inflammation. In infants, the most common cause of dacryocystoceles is a membrane or valve-like structure at the lower end of the nasolacrimal duct, known as the Hasner valve, failing to open properly.

Diagnosis

A dacryocystocele is usually diagnosed through a physical examination of the affected eye. The doctor may gently press on the lacrimal sac to check for swelling and evaluate the flow of tears. In some cases, additional tests such as a dye disappearance test or an imaging study, like a dacryocystogram, may be performed to confirm the diagnosis and determine the extent of the blockage.

Treatment

The treatment of a dacryocystocele depends on the severity of the condition and the age of the patient. In infants, gentle massage of the lacrimal sac and warm compresses may be sufficient to relieve the blockage and promote tear drainage. If these conservative measures fail, a procedure called probing and irrigation may be performed to open the nasolacrimal duct. In adults, surgical intervention is often required to remove the obstruction and restore normal tear drainage.

Complications

If left untreated, a dacryocystocele can lead to recurrent infections of the lacrimal sac, known as dacryocystitis. This can cause pain, swelling, and redness in the affected eye, as well as fever and general malaise. In severe cases, the infection may spread to the surrounding tissues, leading to cellulitis or abscess formation.

See also

• Lacrimal system
• Nasolacrimal duct
• Dacryocystitis