Introduction. Congenital dacryocystocele is
an uncommon consequence of congenital nasolacrimal duct obstruction
: it is believed to occur as a result of a concomitant upper obstruction of the Rosenmuller valve and lower obstruction of the Hasner valve
1 – 3
.
What is congenital Dacryostenosis?
As many as 6 percent of newborns have a blocked tear duct in the eye. This condition is called dacryostenosis or congenital lacrimal duct obstruction, meaning
it’s present at birth
. A blocked tear duct can occur in one or both eyes.
What is congenital Dacryocystitis?
The term “congenital dacryocystitis” is a misnomer. The condition develops after birth, and not before, and is not a true inflammation of the sac wall, but
an infection of the retained excretions from the conjunctival sac
.
What is neonatal dacryocystitis?
Neonatal dacryocystitis is a special type of dacryocystitis that
occurs in less than 1% of all newborns
. The onset is usually acute, and the neonate has a swollen mass in the inferior medial canthal area. Often, there is tearing and a mucopurulent discharge.
What is first treatment in case of congenital dacryocystitis?
Treatment
with oral antibiotics
(eg, amoxicillin-clavulanate) is appropriate. Cultures of the lacrimal fluid may be helpful. The presence of a lacrimal sac mucocele in adults mandates treatment even if asymptomatic. The treatment of choice is a dacryocystorhinostomy whether the patient is symptomatic or not.
What does dacryocystocele mean?
A dacryocystocele is
a cystic bluish swelling
that can develop in the medial canthal area of the newborn within the first 12 weeks of life.
6 , 7
. It is due to accumulation of fluid trapped within the lacrimal sac, which is blocked distally at the nasolacrimal duct and proximally at the common canalicular duct.
What causes dacryocystocele?
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.
What are three signs of Nasolacrimal?
- Constant and severe tearing.
- Painful swelling near the inside corner of the eye.
- Recurrent eye inflammation (conjunctivitis) or tear duct infections (dacryocystitis)
- Mucus or pus discharge from the lids and surface of the eye.
- Blurred vision.
Can congenital Dacryostenosis cause vision problems?
Most often, the far end of the nasolacrimal duct is blocked. The result is an overflow of tears that run down the cheek (epiphora) or
causes persistent crusting
. One or both eyes can be affected. The problem is usually first noticed in 3- to 12-week-old infants.
How do I know if my baby has a blocked tear duct?
A child with a blocked tear duct may have:
more tearing than usual
(even when the child isn’t crying) dried crusting on the eyelashes. mild redness or irritation of the eyes or eyelids (from the child rubbing them)
What is neonatal conjunctivitis?
Neonatal conjunctivitis is
a red eye in a newborn caused by infection, irritation, or a blocked tear duct
. When caused by an infection, neonatal conjunctivitis can be very serious.
Is DCR surgery necessary?
A dacryocystorhinostomy (DCR) is a surgery that creates a new path for tears to drain between your eyes and your nose. You may need this surgery
if your tear duct has become blocked
.
What antibiotics treat dacryocystitis?
Amoxicillin and clavulanate (Augmentin)
Provides useful coverage for most organisms associated with dacryocystitis.
How can you prevent dacryocystitis?
Prevention. You can prevent future infections by having surgery called dacryocystorhinostomy to widen the blocked duct. If you or your child often gets tear duct infections, one way to prevent them is to
drain the tear sac
. Wash your hands, then hold a warm, wet washcloth over the tear sac.
How do you treat dacryocystitis?
Treatment of Dacryocystitis
Acute dacryocystitis is usually treated with
an antibiotic taken by mouth
. If a fever is present or if the infection is severe, antibiotics given by vein may be required. Applying warm compresses to the area several times a day also helps.
