Chronic Dacryocystitis

Etiology: Obstruction of the nasolacrimal duct is often secondary to chronic inflammation of the connective tissue or nasal mucosa.

Symptoms and diagnostic considerations: The initial characteristic of chronic dacryocystitis is increased lacrimation. Signs of inflammation are not usually present. Applying pressure to the inflamed lacrimal sac causes large quantities of transparent mucoid pus to regurgitate through the punctum.

H Chronic inflammation of the lacrimal sac can lead to a serpiginous corneal ulcer.

Treatment: Surgical intervention is the only effective treatment in the vast majority of cases. This involves either a dacryocystorhinostomy (creation of a direct connection between the lacrimal sac and the nasal mucosa; see Figs. 3.10a-c) or removal of the lacrimal sac.

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