Question 1

An adult patient with a history of recurrent sinusitis and allergic rhinitis reports chronic tearing in one eye, ocular discharge, and eyelid crusting. The provider suspects nasolacrimal duct obstruction. Which initial treatment will the provider recommend?

A) Antibiotic eye drops
B) Nasolacrimal duct probing
C) Systemic antibiotics
D) Warm compresses

D

Accepted Answer

Warm compresses can help to relieve symptoms and may help to open the nasolacrimal duct. Antibiotics may be indicated if there is evidence of infection, but warm compresses are a good initial treatment. Nasolacrimal duct probing may be indicated if symptoms persist despite warm compresses. Systemic antibiotics may be indicated if there is evidence of a systemic infection, but are not the first-line treatment for nasolacrimal duct obstruction.

Question 2

A patient is diagnosed with dacryocystitis. The provider notes a painful lacrimal sac abscess that appears to be coming to a head. Which treatment will be useful initially?&#10;A) Eyelid scrubs with baby shampoo&#10;B) Incision and drainage&#10;C) Lacrimal bypass surgery&#10;D) Topical antibiotic ointment

Accepted Answer

Incision and drainage is the most appropriate initial treatment for a painful lacrimal sac abscess that is coming to a head. This will help to relieve the pain, remove the pus, and facilitate healing. Eyelid scrubs with baby shampoo or topical antibiotic ointment may be helpful for preventing future infections, but are not appropriate initial treatments for an abscess. Lacrimal bypass surgery may be necessary for cases of chronic dacryocystitis, but is not indicated for an acute abscess.

Deck 58: Nasolacrimal Duct Obstruction and Dacryocystitis