Chronic Dacryocystitis Case Presentation

The White army
Case Presentation
Chronic dacryocystitis
-AISHWARYA H K
7 th term
BGS GIMS
Bangalore
• Name – Mrs. XYZ
• Age – 40 years
• Gender – Female
• Education – 10 th standard
• Occupation – home maker
• Address-Behind Poorna Prajna College, 5th cross, JPnagar ,
Mysore, 570-001
• Socio economic status –Upper lower class (Kuppuswamy scale )
• DOA - 1/7/2020
• DOE – 2/7/2020
•Chief complaints
• 1) Watering in the Left eye since 6 months

History of presenting illness
• Patient was apparently normal 6 months back, later she

noticed watering in the left eye , insidious in onset.
• There is no history of discharge
• There is no history of excoriation over the cheek skin.
• There is no other swellings found.
• There is no history of pain.
• There is no history of rhinitis, sinusitis
• There is no history of Itching
• There is no history of redness
• There is no history of trauma
• There is no history of Fever
• Ocular history –
There is no history of surgery to the left eye.
• Past history –
There is no history of similar complaints in the past.
Patient is a known case of Diabetes Mellitus on regular
medication ( Metformin )
Patient is a known case of Hypertension on regular medication
(Amlodipine )
No other chronic illnesses.
• Family history – No history of similar illness.
• Personal history -
1. Diet –Predominantly vegetarian.
2. Appetite – Normal
3. Bowel and Bladder movements –Regular
4. Sleep – undisturbed
5. Addictions –not present
6. Drug allergies – not present
• Summary
This is a case of 40 Year old lady , who is an home maker, a
known case of DM and HTN, presented with the complaints of
watering in left eye since 6 months.
•General physical examination
42 year old lady, who is moderatly built and well nourished is
conscious, cooperative, alert, oriented to time, place and
person.
Weight – 70 Kg
Height – 165 cm
BMI-27.3 Kg/m².
No pallor, icterus, clubbing, cyanosis ,lypadenopathy, edema.

•Vitals.
1. Pulse rate -65 bpm
2. Blood pressure – 128/80 mmHg measured in left
arm, sitting position
3. Respiratory rate -15 cycles per minute.
4. Temperature- Afebrile.
•Systemic examination.
1. CVS –S1 and S2 heard.
2. Respiratory system –B/L Normal Vesicular breath sounds
heard .
3. CNS –No focal neurological deficits.
4. Per abdomen – Soft and non tender.
Ocular examination
1. Head posture – erect
2. Facial symmetry – symmetrical
3. Ocular posture –orthotropic.
Ocular examination Right eye Left eye
1. Visual acuity
• Distance vision Counting finger ,more than 6 Counting finger, more than 6
meters meters.
• Near vision Normal Normal
2. Eye brows
• Position. Normal Normal
3.Eyelids – position Normal Normal And no ectropion or entropion
• Palpebral aperture width Length -30 mm, height 10mm Length -30 my, height -10 mm
4)Lacrimal aparatus - Lacrimal sac Normal Normal.
• Lacrimal puncta Normal Increased watering from the eye is seen.
• Regurgitation test Negative Purulent discharge.
• Lacrimal gland Normal Normal
5) Eyeball – size, position, movements of Normal Normal

eyeball, uniocular movements, binocular
movements
6)Conjunctiva – Palpebral, bulbar Normal Normal
conjunctiva and conjunctivaa fornices
Ocular examination Right Left
7) Cornea – size, shape, surface, sheen, Normal Normal

sensations, transparency
8) Sclera Normal Normal
9) Anterior chamber – depth and Normal Normal

contents
10 Iris - color and pattern Brown color, normal pattern Brown color, normal pattern
11)Pupil - Central, round, blackish Central, round, blackish.

Pupil -pupillary reactions
• Direct light reflex Constriction of pupil present Constriction of pupil present
• Indirect light reflex Constriction of pupil on both the sides Constriction of pupil on both the sides
• Near reflex Constriction of pupil, convergence of Constriction of pupil, convergence of

eyeball present eyeball present
12)Lens-position , shape, color, Normal Normal

transparency
14) IOP ( by digital tonometry ) Normal Normal

Differential diagnosis –
1. Chronic Dacryocystitis.
2. Foreign body in NLD.
3. Trauma to NLD or punctum or canaliculi.
4. Nasal polyps.
5. Deviated nasal septum.
6. Turbinate hypertrophy.
Provisional diagnosis
• After taking the history and doing the ocular examination,
probable diagnosis can be Chronic Dacryocystitis of the left
eye, chronic suppurative stage.
Thank you

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The White army

• 1) Watering in the Left eye since 6 months

• Patient was apparently normal 6 months back, later she

No pallor, icterus, clubbing, cyanosis ,lypadenopathy, edema.

• Position. Normal Normal

3.Eyelids – position Normal Normal And no ectropion or entropion

4)Lacrimal aparatus - Lacrimal sac Normal Normal.

• Lacrimal puncta Normal Increased watering from the eye is seen.

• Regurgitation test Negative Purulent discharge.

• Lacrimal gland Normal Normal

5) Eyeball – size, position, movements of Normal Normal

7) Cornea – size, shape, surface, sheen, Normal Normal

8) Sclera Normal Normal

9) Anterior chamber – depth and Normal Normal

11)Pupil - Central, round, blackish Central, round, blackish.

Pupil -pupillary reactions

• Direct light reflex Constriction of pupil present Constriction of pupil present

• Near reflex Constriction of pupil, convergence of Constriction of pupil, convergence of

12)Lens-position , shape, color, Normal Normal

14) IOP ( by digital tonometry ) Normal Normal

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