A Five-Year Retrospective Review of the Clinical Spectrum and Management Pattern of Dacryocystitis in a Tertiary Care Hospital of Coastal Karnataka

Author(s): Anagha Dinesh1, Sheetal Savur2

Dacryocystitis is the most common pathology affecting lacrimal drainage system,
representing 79 - 87 % of all lesions. This retrospective study was conducted to
understand the clinical spectrum and management patterns of dacryocystitis in
the past 5 years in a tertiary care hospital of coastal Karnataka.
This is a five-year retrospective review of the case records of patients with
dacryocystitis from the year 2015 to 2019. The records were retrieved from the
electronic medical record system of the hospital using the International Statistical
Classification (ICD) 10 codes. Data retrieved included, demographic profile, clinical
history, presenting symptoms, past surgical interventions, examination findings,
systemic comorbidities, pattern of management, medical or surgical management
and complications if any. 45 cases that had completed medical records were
included in the study.
The mean age of presentation was 49.37 (± 19.59). The condition was more
common in females with a male to female ratio of 1:2.5. The condition was almost
equal on both sides. 11 (24.44 %) had bilateral involvement. The patients were
mostly from coastal areas or dry plains. Most common presentation was chronic
dacryocystitis. Aggravated epiphora was the most common symptom (33) 73.3 %.
Diabetes mellitus (15) and hypertension (10) were the most common systemic
comorbidities. (22) 48.8 % had no comorbidities. The complications seen were (4)
8.9 % fistula, (1) 2.2 % lacrimal abscess, (2) 4.4 % conjunctivitis and (1) 2.2 %
preseptal cellulitis. The patients who underwent nasal examination were (31) 68.9
% out of which, 26 had no abnormal finding in the nose. Surgical treatment was
performed in 29 (64.4 %) mainly in the form of dacryocystectomy (DCT) 24 (53.3
%) while only 5 (11.1 %) underwent conventional dacryocystorhinostomy (DCR).
Chronic dacryocystitis is the most common form of presentation with higher
incidence in the females in the fifth decade of life. Epiphora was the commonest
symptom. Most patients who underwent a preoperative nasal examination did not
have any pathology. DCT was the more commonly performed procedure.