Acute dacryocystitis is an acute suppurative inflammation of the lacrimal sac, which obstructs the tear duct, causing stagnation of tears in the nasal-lacrimal ducts. The lacrimal excretory system is prone to infection and inflammation as it is contiguous with the conjunctival and nasal mucosa, which is often colonized with streptococcus, staphylococcus or pneumococcal bacteria. This makes the area as a whole vulnerable to infection, especially in those with chronic dacryocystitis.

Signs and symptoms include acute localized pain, with dull aching in the diffuse stage and throbbing in the acute stage. The area below the inner canthus may be hot, red and swollen. There can be fever, headache, tearing and malaise. Western medical treatment consists of hot compresses, antibiotics and analgesics. Surgical lancing is only indicated if the infection will not resolve with the above treatment.

In TCM, acute dacryocystitis pertains to the category of lòu jīng chuāng (漏睛疮, weeping canthus sore). It is an eye condition associated with sudden distending pain, redness, swelling and induration under the point BL 1 ( jīng míng) of the inner canthus, which is formed by purulent eye ulceration. Below the inner canthus point BL 1 ( jīng míng) of the affected eye, there will be acute redness, swelling and pain with constant tearing. Severe cases can be associated with fever, headache, aversion to cold and general malaise. At the initial examination, symptoms present with an aversion to touch. The redness and swelling can reach the nasal bridge and the facial area on the affected side. The eyelid may have difficulty opening. A few days after the onset, the redness and swelling will become localized, gradually forming pus, which eventually ulcerates. At this time the redness and swelling will subside, but can often reoccur leaving a persistent and open lesion with frequent spontaneous pus drainage. This condition is often seen in middle-aged women, more often unilaterally. It may occur suddenly or subsequent to an infection of the lacrimal sac.

The etiology of this condition stems mainly from congested heat in the heart channel or from the original infection of the lacrimal sac, resulting in an internal congestion of toxic heat coupled with invasion of an external wind pathogen. Alternately, toxic heat in the heart and spleen causes qi and blood stasis, with a disharmony of ying and wei qi. The congestion accumulates to form a sore while the excessive heat stagnation forms pus.