Risk factors for the development of acute dacryocystitis in adults

Acute dacryocystitis (AD) is primarily related to nasolacrimal duct obstruction and is associated with a high morbidity, particularly in the elderly. This study aims to determine patient-related and weather-related risk factors of developing AD in adults with and without primary acquired nasolacrimal duct obstruction (PANDO).

Retrospective single-centre observational study of all adult patients with a clinical diagnosis of AD between January 2000 and February 2020. The monthly average of air temperature, air humidity, air pressure and precipitation was collected from the Royal Meteorological Institute of Belgium over the same 20-year time period. Patients had a PANDO, non-PANDO or uncategorised status based on available data on lacrimal syringing.

The study comprised 106 patients with first-onset AD, of whom 86 (81%) were female and 20 (19%) male, with a mean age of 64.9 years. PANDO was found in 50% of the patients, non-PANDO in 20% and 30% could not be categorised. The incidence of AD was overall significantly associated with age, with an increase of 14.5% for every 5-year age increase (p=0.012, Exp(B)=1.145). In particular, in the PANDO group, the risk increased by 22.1% for every 5-year age increase (p<0.002, Exp(B)=1.221). This association was not evident in the non-PANDO group. There was no significant association between the incidence of AD and any of the weather variables.

AD is more common in women and the risk of development increases significantly with ageing, especially when underlying PANDO is present. This risk assessment can be useful in the counselling of elderly female patients with symptomatic PANDO about AD-preventive dacryocystorhinostomy.