H04.57

Clinical Causes: Chronic inflammation or infection (dacryocystitis) Congenital abnormalities leading to narrowed tear ducts Trauma or injury to the eye area Formation of scar tissue after surgery or infection Age-related changes causing tissue degeneration Tumors or growths obstructing the tear pathway Foreign bodies or debris causing blockage

Key Symptoms: Persistent tearing or watery eyes, especially near the inner corner Swelling, redness, or tenderness around the lacrimal sac Recurrent episodes of inflammation or infection Discharge from the eye, possibly purulent A feeling of pressure or fullness near the nose bridge Blurred or decreased vision in some cases Crusting around the eyelids and eyelashes

Diagnosis Path: The diagnosis of lacrimal sac stenosis involves a detailed medical history and physical examination of the eye and surrounding area. The healthcare provider may perform specialized tests, such as: - Dacryocystography: imaging that uses contrast dye to visualize the tear drainage system. - Fluorescein dye disappearance test: assesses tear flow and drainage efficiency. - Syringing and probing: manual evaluation of the tear duct patency. - Imaging studies such as ultrasound or CT scan in complex cases. These assessments help determine the location and extent of the blockage, guiding appropriate treatment decisions.

Treatment Protocols: Treatment options aim to restore normal tear drainage and alleviate symptoms. They include: - Conservative management: Warm compresses and gentle massage may help in mild cases, especially if inflammation is present. - Medical therapy: Antibiotics or anti-inflammatory medications for associated infections or inflammation. - Surgical procedures: - Dacryocystorhinostomy (DCR): a common procedure creating a new passage between the lacrimal sac and the nasal cavity. - Balloon dacryoplasty: minimally invasive method to dilate narrowed tear ducts. - External or endoscopic approaches depending on the case and surgeon preference. Postoperative care involves antibiotics, eye drops, and follow-up visits to ensure proper healing and function.