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Conjunctiva
Chronic Dacryocystitis
Etiology:-
Glaucoma
Optic Nerve
Errors of Refraction
- Stricture.
- Congestion because the lower end of the wall has an erectile tissue. It becomes congested due to hormonal
Squint
Tumours
Ocular Trauma
Field of Vision
IV. Obstruction at the nasal end of NLD for example by deviated septum and nasal polyps.
B. Causes of infection (precipitating factors):
The Pupil
As congenital dacryocystitis.
Miscellaneous Subjects
Clinical picture:-
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Symptoms:
- Watering of the eye especially in cold or dusty atmosphere.
- Swelling below the MPL.
Signs:
Calendar
- As congenital dacryocystitis.
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- Exclusion of other causes of lacrimation and epiphora should be done as the presence of ectropion and orbicularis
paresis.
Investigations:
A. To confirm the presence of obstruction:
1. Fluorescein clearance test: A drop of fluorescein should normally disappear from the conjunctival sac within
5 minutes.
2. John's dye test: If a piece of cotton is put in the inferior meatus of the nose and a fluorescein drop in the eye,
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needle. If could reach the nose under pressure, thus there is partial obstruction.
3. Lacrimal irrigation with saline and adrenaline: A diluted solution of adrenaline is injected. If it could reach the
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Chronic Dacryocystitis
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nose, thus the cause of obstruction is congestion of NLD. If it could not, the cause is stricture.
4. Radiography:
i. Plain X - ray to show bone lesions as malunion of maxillary fractures.
ii. Dacryocystography: A dye is injected into the lacrimal passages and serial X - ray films are taken. It
may show:
* Abrupt NLD obstruction in cases of tumours.
* Rat tail appearance in cases of stricture of NLD.
* No obstruction, but delayed emptying of lacrimal sac in cases of functional lacrimal obstruction. It
occurs due to paralysis of the lacrimal portion of O.O..
* The dye can not enter the sac in cases of canalicular obstruction.
iii. Lacrimal scintillography:
* Radioactive eye drops are instilled and its movement through the lacrimal passages is monitored
(very accurate).
Statistics
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