Clinicobacteriological study of chronic dacryocystitis in adults.
ABSTRACT Chronic dacryocystitis is the inflammation of lacrimal sac, frequently caused by bacteria. Obstruction of nasolacrimal duct converts the lacrimal sac a reservoir of infection. It is a constant threat to cornea and orbital soft tissue. Moreover, it causes social embarrassment due to chronic watering from the eye. This study was conducted to find out the current clinicobacteriological profile of chronic dacryocystitis in adults. A total of 56 adult patients were selected from ophthalmology OPD. Detail history and clinical examinations were carried out. All patients underwent either dacryocystorhinostomy or dacryocystectomy. A part of the sac was collected for culture and sensitivity. This study revealed that chronic dacryocystitis is more common in females and left eye is more frequently involved than right eye. It is common among lower socioeconomic strata with habit of pond-bathing. Some form of nasal pathology like hypertrophied inferior turbinate, deviated nasal septum, nasal polyp and allergic rhinitis werefound in 19.6% of the patients. Complications of chronic dacryocystitis like conjunctivitis, corneal ulcer, acute on chronic dacryocystitis, lacrimal abscess and fistula were seen in 25.0% of these patients; 53.6% of the culture samples were positive for bacterial growth. Gram-positive organisms were most common isolate. Unlike other studies, Staphylococcus aureus (40.0%) was found to be most common Gram-positive organism, followed by Staphylococcus epidermidis (10.0%) and Steptococcus pneumoniae (10.0%). Among the Gram-negative organisms, Pseudomonas aeruginosa (16.6%) was the most common, followed by Klebsiella pneumoniae (6.6%) and Haemophilus influenzae (6.6%). Antibiotic sensitivity tests were done. Most of the organisms were resistant to penicillin. Chloramphenicol was effective against most of the Gram-positive organisms. Aminoglycosides, tobramycin in particular, was effective against Staphylococcus epidermidis. Fluoroquinolones, namely ciprofloxacin and ofloxacin were effective against Pseudomonas aeruginosa and Klebsiella pneumoniae.
- Journal of the All-India Ophthalmological Society 07/1967; 15(3):107-10.
- [show abstract] [hide abstract]
ABSTRACT: A total of 171 isolates of Streptococcus pneumoniae were obtained from eyes of children who had congenital dacryocystitis, congenital cataract and glaucoma, acute bacterial conjunctivitis, corneal ulceration, nasolacrimal duct block, or discharging socket, or who had developed ectropion, endophthalmitis and orbital cellulitis. The highest number of strains was obtained from cases of dacryocystitis (74.4%), followed by conjunctivitis (8.2%) and those having developed nasolacrimal duct block (7.6%). The least overall resistance was to erythromycin (17.6%) and chloramphenicol (31.0%). Erythromycin being unavailable for ocular use in India, chloramphenicol was reported to be one of the best drugs against pneumococcal ocular infections in children, the other being cloxacillin, a 2.5% solution of which is made from injectable cloxacillin and used as an ophthalmic preparation. Their use on patients has met with considerable success. Nineteen out of 20 isolates were typeable--the types being 3, 46, 8, 28, 29, 45, 21 and 18. To the best of our knowledge, this is the first report from a developing country of serotyping ocular strains of pneumococci.Annals of Tropical Paediatrics International Child Health 01/1988; 7(4):270-3. · 0.92 Impact Factor
- A Clinico-bacteriological study of chronic dacryocystitis. 1974. Ophthalmology 83 275-279..
AIOC 2010 PROCEEDINGS
Dr. JYOTI BHUYAN: M.B.B.S. (1983), Gawahati Medical College, Assam; M.S (1988), RIO,
Gawahati Medical College, Assam. Presently Associatate Professor.
A Clinicobacteriological Study on Chronic Dacryocystitis
Dr. Jyoti Bhuyan, Dr. Subhajit Das
(Presenting Author: Dr. Jyoti Bhuyan)
and conspicuous symptoms it may cause, partly
because it has little tendency to resolve. This
study was carried out in RIO Guwahati with the
objectives of: 1) Identifying the causative bacteria,
2) Studying the antibiotic sensitivity of these
bacterias to commonly used antibiotics and 3)
occupation and socioeconomic status.
Materials and Methods
Sixty cases of clinically established chronic
Dacryocystitis, who attended and were treated in
RIO, GMCH during the period from July 2008 to
June 2009 were selected for this study. Cases that
did not use any antibiotic drop previously or
stopped using antibiotic eye drop at least one
week before attending the hospital were taken for
this study irrespective of age, sex, occupation and
social status. Sterile swab sticks were used for
collection of regurgitated material. For bacterial
1. Stain – Gram’s Stain, KOH (10%).
2. Culture medium – Blood Agar, Mc Conky`s
Agar, Nutrient Agar, Chocolate Agar were used.
Three swabs were collected at a time. First for the
KOH smear, second for the Gram staining and
hronic Dacryocystitis is an unpleasant
disease, partly because of the troublesome
last swab for culture in medias. Swabs were sent
to Microbiology department for study.
Different results were observed in this study.
Table-1: Shows age Distribution
Age Groups (yrs)
Table 1 shows that the max. number of patients
are in the 4th decade (23.33%) followed by 5th
decade( 21.66). The present study shows that out
of 60 patients 46(76.66%) are females and 14
(23.33%) are males in the ratio of 3.28:1.
Our study shows that out of 60 patients 38
(63.33%) are housewives, 10 (16.66%) are farmers,
4(6.67%) are service holders, 4(6.67%) are
students, 3(5%) are shopkeepers and 1(1.67%) are
No. of Cases
Our study shows that out of 60 patients
29(21.66%) belong to upper class and 31 (78.33%)
belong to lower class.
Regarding presenting symptoms our study
shows that watering is present in all cases (100%),
while mucopurulent discharge is present in
25(41.66%) cases and swelling over lacrimal sac
region is seen in 10(16.66%) cases.
It has been observed that out of 60 patients of
chronic dacryocystitis clear fluid regurgitation is
found in 29(48.33%) patients, followed by
mucopurulent fluid regurgitation in 23(38.33%)
and purulent regurgitation in 8(13.33%) patients
Table-2: Bacteriological Examination
No of Cases
Table 2 shows that the commonest organism is
staphylococcus aureus (28.33%), followed by
streptococcus pneumoniae (23.33%).
Regarding sensitivity test our study shows that
Staph. Aureus is most commonly sensitive
against ciprofloxacin and gentamycin. Strep.
Pneumoniae is sensitive against ciprofloxacin
and Ampicillin. Overall sensitivity testing shows
that most effective antibiotic against all bacteria is
ciprofloxacin (80.76%) followed by Gatifloxacin
(46.15%), Chloramphenicol (42.30%), Tetracyclin
(44.23%), and Cloxacillin (32.69%).
The observations made in this study was more or
less similar to those of other previous authors. In
our study of 60 cases maximum number of
patients were in the 4th decade (23.33%) followed
by 5th decade (21.66%) & 3rd decade (20%) of
life. Sood et al 1 in 1967 and Visootr Chayakul et
al 2 in 1984 reported similar result. In this study
females 76.66 %( 46) were affected more than the
males 23.33 % ( 14). Duke-Elder (1974) 3 and
Trevor Roper et al 4 in 1974 made the similar
observation. The incidence of dacryocystitis was
more among housewives (63.33%) in our study.
Similar result was observed by Duke-Elder (1974)
3. Regarding social status our observation of
class(78.33%) was similar to that of Duke-
Elder(1974) 3 and Visootr Chayakul et al 2 in
observation was similar to Khurana AK 5 in 1996.
Predominant organism in our study was
Staphylococcus aureus (28.33%) followed by
Streptococcus pneumoniae (23.33%). Similar
results were stated by Prasad et al 6 (1958), Sood
et al 1 (1967) & D.V.Seal et al 7 (1982). While
examining the sensitivity test we found that the
most sensitive antibiotics were Ciprofloxacin
(69.23%), Gentamycin (67.30) & Tobramycin
(61.5%). Similar results were observed by Seal
D.V.et al 7 in 1982, Jain M.R. 8 in 1992 and
Mahajan VM et al 9 in 1987.
We conclude by saying that the present study
tried to find out the commonly involved
causative organism in chronic dacryocystitis and
helped to treat the patients with proper
antibiotics. It also studied local and general
predisposing factors causing dacryocystitis.
1.Sood NN, Ratnaraj A, Balaraman G, Madhavan HN,
study, Indian J Ophthalmol 1967; 15:107-10.
Visootr Chayakul: Studies on dacryocystitis and
dacryocytorhinostomy. X Congress APAO; 183-185,
Duke-Elder, 1974: System of Ophthalmology, edited
by Duke-Elder, Vol-13, part 2, 700-714, 1974.
Trevor Roper: A Clinico-bacteriological study of
chronic dacryocystitis, Ophthalmology; 83 (2): 275-
A K Khurana, Comprehensive Ophthalmology 2007
B Prasad, D Ram, G Prasad. Histological changes
Ophthalmology; vol: 6(4); P: 71-77 Year 1958.
D.V.Seal, J.I.Mcgeal: Etiology and treatment of
bacterial infections of external eye. : British Journal
of Oph. 66:357-370.,1982
Jain M.R.,: Clinical evaluation of Ciprofloxacin
drops in bacterial keratitis
MahajanVM, Bareja U. Prakash K.: Pneumococci in
ocular disease of children and their treatment.
Annals of Tropical Paediatrics.7:270-273, 1987.