title: Clinical profile and management outcome of acute dacryocystitis: two decades of experience in a tertiary eye care center.
abstract: OBJECTIVE
  To report the demographic profile, clinical presentation, and management outcome of acute dacryocystitis.
  
  
  METHODS
  Retrospective study of 347 eyes of 320 patients, who presented to the Ophthalmic Plastic Clinic of a tertiary eye care center over a period of 22 years from January 1990 to March 2012 with acute dacryocystitis, were reviewed for demographic profile, clinical presentation, and management outcome. The numbers of patients with lacrimal disorders during the same period were retrieved to assess the incidence of acute dacryocystitis. Successful anatomical outcome was defined as patency on irrigation and a successful functional outcome was defined as resolution of infection and epiphora.
  
  
  RESULTS
  The mean age at presentation was 37 years. The female to male ratio was 2:1. There was no difference in the laterality between the right and the left eyes. Bilateral disease was noted in 8.4% (27/320) patients. 23% (80/347) eyes presented with lacrimal abscess while 2.8% (10/347) eyes had orbital cellulitis. Intensive medical care with hospital admission was needed in 4.4% (14/320) patients. The mean time to resolution of acute symptoms was 10 days. 5.6% (18/320) patients developed a fistula, among which 83% (15/18) were following a spontaneous rupture of the lacrimal abscess. Dacryocystorhinostomy was performed in 82.5% (264/320) patients with an anatomical success of 94.5% and a functional success of 93.5%.
  
  
  CONCLUSIONS
  Acute dacryocystitis comprises 2.4% of all patients presenting with lacrimal system disorders. Fistula formation is a sequel more commonly seen with spontaneous rupture of a lacrimal abscess. The long-term outcomes in patients presenting with acute dacryocystitis are good with a surgical success rate of 94.3%.
authors.affiliation: Dacryology Service, Ophthalmic Plastics Surgery, L.V. Prasad Eye Institute , Hyderabad , India.
authors.forename: Mohammad Javed
authors.initials: MJ
authors.lastname: Ali
authors.forename: Surbhi D
authors.initials: SD
authors.lastname: Joshi
authors.forename: Milind N
authors.initials: MN
authors.lastname: Naik
authors.forename: Santosh G
authors.initials: SG
authors.lastname: Honavar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003607:Dacryocystitis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007767:Lacrimal Duct Obstruction / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000473:pathology; D009885:Ophthalmology; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents
keywords: Acute; abscess; dacryocystitis; dacyrocystorhinostomy; lacrimal