A Rare Case of Bilateral Chronic Dacryocystitis: Due to Punctum Stenosis and Nasolacrimal Duct Obstruction After Onset Thermal Injury

Chronic dacryocystitis is inflammation of the lacrimal sac caused by obstruction of the lacrimal drainage system. The condition often causes chronic epiphora, pain, swelling and recurrent infection. Thermal trauma is a rare but significant cause of chronic dacryocystitis, which contributes to fibrosis and progressive obstruction. This case report brings to light a rare presentation of bilateral chronic dacryocystitis due to childhood thermal trauma. A 24-year-old woman presented with complaints of lumps on both lower eyelids with acute exacerbation of pain, swelling and redness in the right eye and epiphora. The patient had a history of facial burns from fireworks sparks when she was 10 years old, which was suspected to cause bilateral punctum stenosis. Clinical examination revealed punctum stenosis and imaging confirmed bilateral chronic dacryocystitis with significant obstruction of the lacrimal drainage. External dacryocystorhinostomy (DCR) procedure with silicone tube insertion was planned as the definitive therapy to restore lacrimal drainage. Chronic dacryocystitis due to thermal trauma is a rare condition involving progressive fibrosis and obstruction of the lacrimal drainage system. Prolonged obstruction increases the risk of recurrent infection and psychosocial consequences due to facial deformity. External DCR, with a success rate of up to 95%, is the main therapeutic option to restore lacrimal drainage function. Bilateral chronic dacryocystitis due to childhood thermal trauma is a rare and complex condition that requires early diagnosis and evidence-based therapy. External DCR is an effective intervention to restore function and improve patients' quality of life.