Specific Management: Dacryoadenitis and Dacryocystitis

Viral dacryoadenitis, usually occurring with a systemic viral illness (e.g. Mumps, Epstein-Barr virus), is typically self-limiting with treatment aimed at symptomatic relief with analgesia. If bacterial infection is suspected (e.g. isolated swelling without intercurrent viral illness), a course of oral antibiotics is indicated.

As dacryocystitis is normally caused by secondary bacterial infection of an obstructed lacrimal system, antibiotic treatment is required. Anaerobic organisms may be present and therefore an agent providing some anaerobic cover (e.g. co-amoxiclav) is advised. Occasionally, in non-responding cases, surgical drainage may be required, and is important to prevent recurrence. All patients presenting to the ED with dacryocystitis should be referred to an ophthalmologist for follow-up.