Dacryolith Definition, Symptoms, Causes, Treatment

Dacryolith is the cast formation which occurs inside the nasolacrimal sac. The formation of dacryolith may produce obstruction of the normal lacrimal drainage. Basically the shed epithelial cells form the dacryolith. Other than shed epithelial cells, amorphous debris and lipids also form dacryolith. It either contain traces of calcium in it or does not have calcium traces. Usually there isn't any abnormality or inciting event is reported in dacryolith. Dacryolith is a usual condition and may occur secondary to some medications like topical epinephrine. Infection related to some specific species i.e. candida species or actinomyces Israelii.

Dacryolith may form in patients having normal lacrimal drainage system. Dacryolith is the condition, which when occurs leads to intermittent symptoms. Symptoms also depends upon the location of formation of dacryolith. Dacryolith may occur secondary to any preexisting obstruction, in this case,  the symptoms are unremitting. Acute impaction of the dacryolith in the normal lacrimal drainage may leads to distension of lacrimal fluid sac. Substantial pain is associated with this acute impaction of dacryolith. During DCR, dacryolith cast can be easily removed. Dacryolith is like a stone which is hard on touch and can be felt easily without touching. Pain confirms the formation of dacryolith.

Dacryolith Definition, Symptoms, Causes, Treatment

Dacryolith Symptoms

The symptoms of dacryolith are intermittent. Patient feels pain. Intermittent epiphora is the main symptom which occurs without inflammation. There is no recurrent dacryocystitis. In some cases , dacryoliths formation can be associated with acute or chronic dacryocystitis. In some cases, inflammation may also occur. The symptoms of dacryolith may be intermittent or persistent and it all depends on the location of dacryolith cast. If Dacryolith forms in the normal lacrimal drainage due to the preexisting obstruction, intermittent symptoms appear. Patient may feel pain and itching at the location of occurrence if Dacryolith cast in lacrimal drainage.

Dacryolith Causes

Dacryolith can occur due to many reasons. The exact main cause is still unknown. But the reported main causes include some infections. Infection because of actinomyces Israelii and candida species are responsible for the formation of Dacryolith. It may occur secondary to some medications like epinephrine. Secondary to medications, the cast formed is easier to cure. Long term administration of topical medications contribute a lot towards its formation. It usually occur in patients with normal lacrimal drainage system. There is not any gender priority as it equally effects both male and female. Its occurrence is sudden.

Dacryolith Treatment

Dacryolith is treated with a surgical process named dacryocystorhinostomy. Its abbreviation is DCR. In this procedure, the epiphora or Dacryolith is teared due to the blockage of lacrimal duct of nose. Another procedure named endoscopic Dacryolith is performed to treat any obstruction in the lacrimal duct. It is a simple process and patient will take about 7 to 10 days to recover completely. In this procedure, a hole is made between the inner side of nose and the tear sac. And this hole helps in the removal of debris from the sac. The debria or lipids which accumulate in the lacrimal drainage system, can be easily removed with this surgery.

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