Dacryocystitis is an infection of the tear sac. The tear sac is the narrow pouch where tears from the eye drain before they flow into the nose. There is one tear sac for each eye.
Tears moisten and clean the eyes. They are made in a gland under the upper eyelids. Tiny tubes called tear ducts drain excess tears away from the eyes. The tears flow into the tear sacs, and then into the nose.
In some cases, a tear sac can get infected. This can happen if the tear duct is blocked. A blocked duct can happen for many reasons. It is most common in babies. The tear duct can be partly blocked from birth until 12 months of age. The problem usually goes away by this time. Some children may have a blocked duct beyond 12 months of age. A blocked duct may be caused by an injury to the nose or eye.
A blocked tear duct can’t drain tears. Bacteria may then become trapped in the duct and in the tear sac. Dacryocystitis can cause redness, swelling, and pain just below the lower lid, near the nose. A fluid (pus) may drain from the eye. Your child may have a fever. He or she may also have pain in the mouth, cheeks, or other areas of the face.
Antibiotics are used to treat the infection and stop it from spreading. If the infection doesn’t go away, or comes back often, your child may need minor surgery to open the duct.
You will be given antibiotic medicine to treat your child’s infection. Follow all instructions for giving this medicine to your child. It may be taken by mouth. Or it may be eye drops or eye ointment. If your child has pain, you can give him or her pain medicine as advised by your child’s health care provider. Don’t give your child aspirin unless told to do so. Don’t give your child any other medicine without first asking the provider.
Wash your hands before caring for your child’s eye. Keep your nails cut short to avoid scratching the eye area.
Several times a day, apply a warm compress for 1 to 2 minutes. A warm compress is a clean towel damp with warm water.
After the warm compress, massage the tear sac with clean hands. Place your index finger between the corner of the eye and the nose. Your finger should be pointing toward the top of the nose. Gently massage from the nose toward the eye. A small amount of tear fluid or pus may appear in the corner of the eye.
Using eye drops: Apply drops in the corner of the eye where the eyelid meets the nose. The drops will pool in this area. When your child blinks or open his or her eyelid, the drops will flow into the eye. Use the exact number of drops prescribed. Be careful not to touch the eye or eyelashes with the dropper.
Using ointment: If both drops and ointment are prescribed, give the drops first. Wait 3 minutes, and then apply the ointment. Doing this will give each drug time to work. To apply the ointment, start by gently pulling down the lower lid. Place a thin line of ointment along the inside of the lid. Begin at the nose and move outward. Close the lid. Wipe away excess medication from the nose area outward. This is to keep the eyes as clean as possible. Have your child keep the eye closed for 1 or 2 minutes so the medication has time to coat the eye. Eye ointment may cause blurry vision. This is normal. Apply ointment right before your child goes to sleep. In infants, the ointment may be easier to apply while your child is sleeping.
Make sure your child does not rub his or her eyes.
Follow up with your child’s health care provider.
When to seek medical advice
Call your child's health care provider right away if any of these occur:
Fever of 100.4°F (38°C) or higher
Symptoms don’t get better, or get worse