Infected Tear Sac (Dacryocystitis)
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. You have 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 may be caused by an injury to the nose or eye. Or the duct may have narrowed on its own. 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 milky fluid (pus) may drain from the eye. Antibiotics are used to treat the infection and stop it from spreading. If the infection doesn’t go away, or comes back often, minor surgery may be needed to open the duct.
Home care
Follow these guidelines when caring for yourself at home:
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You will be given antibiotic medicine to treat the infection. Follow all instructions for taking this medicine. It may be taken by mouth. Or it may be eye drops or eye ointment. If you have pain, you may use acetaminophen or ibuprofen to reduce pain and fever. Talk with your healthcare provider before using these medicines if you have chronic liver or kidney disease. Also talk with your provider if you have ever had a stomach ulcer or gastrointestinal bleeding.
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Wash your hands before and after caring for your eye.
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Apply a warm compress for 1 to 2 minutes several times a day. A warm compress is a clean towel damp with warm water.
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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
If you have difficulty using eye drops you can apply drops in the corner of the eye, where the eyelid meets the nose. The drops will pool in this area. When you blink or open your eyelid, the drops will flow into the eye. Use the exact number of drops prescribed. Be careful not to touch your eye or eyelashes with the dropper.
Using ointment
If both drops and ointment are prescribed, use the drops first. Wait at least 3 minutes, and then apply the ointment. Doing this will give each medicine time to work. To apply the ointment, start by gently pulling down your lower lid. Place a thin strip of ointment along the inside of the lid. Begin at the nose and move outward. Close the lid. Wipe away excess medicine from the nose area outward. This is to keep the eyes as clean as possible. Keep your eye closed for 1 or 2 minutes so the medicine has time to coat the eye. Eye ointment may cause blurry vision. This is normal. It may help to apply ointment at bedtime instead of during the day.
Follow-up care
Follow up with your healthcare provider, or as advised.
When to get medical advice
Call your healthcare provider right away if any of these occur:
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Fever of 100.4°F (38°C) or higher after 2 days of antibiotic treatment, or as advised by your healthcare provider
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You just had surgery or another medical procedure or were just discharged from the hospital
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Symptoms don’t get better, or they get worse