Age Ups Risk for Acute Dacryocystitis in Blocked Tear Ducts

TOPLINE:

Acute dacryocystitis (AD) is common in women and becomes increasingly likely with age, particularly in individuals with primary acquired obstruction of the tear duct. To prevent this condition, clinicians may recommend surgery to create a new drainage pathway for tears in individuals aged 70 years or older who present symptoms such as excessive tearing or cysts filled with mucus in the eye.

METHODOLOGY:

• Researchers conducted a retrospective observational study to determine the risk factors for AD in adults with or without primary acquired obstruction of the tear duct.
• They analyzed 106 patients (mean age, 64.9 years; 81% women) diagnosed with AD between January 2000 and February 2020, considering only the first attack in case of recurrent episodes; those with congenital or secondary acquired obstruction of the tear duct were excluded.
• AD was diagnosed when a patient suddenly developed swelling, redness, or pain in the inner corner of the eye, with or without a history of excessive tearing, an obstruction of the tear duct, or the presence of a cyst in the tear drainage system.
• Patients were classified as having primary acquired obstruction of the tear duct if flushing the affected side with saline (before the onset of AD or after the infection calmed) showed a blockage.
• Monthly averages of data on temperature, humidity, pressure, and amount of precipitation were collected from the Royal Meteorological Institute of Belgium over the entire duration of the study.

TAKEAWAY:

• Half of the patients had a blockage in the tear duct, 20% had no blockage, and the rest could not be classified because data on flushing were missing or incomplete.
• The incidence of AD rose significantly with age, with the risk increasing by 15.8% for every 5-year increase in age (exponentiated coefficient [Exp{B}], 1.158; P = .008).
• In patients with a blockage of the tear duct, the risk rose by 22.1% for every 5-year increase in age (Exp[B], 1.221; P = .002); however, no association was observed between increased age and the risk for AD in patients with an open tear passage.
• The incidence of AD was not statistically linked to any changes in the abovementioned weather conditions during the 14 days prior to infection onset.

IN PRACTICE:

The elevated risk for AD in older women with primary acquired nasolacrimal duct obstruction suggests the threshold to perform dacryocystorhinostomy should be lower for these patients, the researchers wrote. They proposed age 70 years as when clinicians should consider preventive dacryocystorhinostomy in patients with symptoms of primary acquired nasolacrimal duct obstruction, such as epiphora or mucocele.

SOURCE:

This study was led by Amber Demeuleneere of the Department of Ophthalmology at the University Hospitals Leuven, Leuven, Belgium. It was published online on June 18, 2025, in British Journal of Ophthalmology.

LIMITATIONS:

Mostly patients with severe AD were seen at the referral center. Those with blockage of the tear duct were not followed up over time. The use of weather averages on a monthly basis may have masked the effects of shorter durations of weather phenomena.

DISCLOSURES:

No grant support was received for this study. No relevant conflicts of interest were disclosed.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.