Aims: The present study was done to determine the clinical pattern and microbiological spectrum of pathogens implicated in causation of acute and chronic dacrocystitis, and their antibiotic susceptibility. Settings & Design: A prospective hospital based cross sectional study for a period of two years at a tertiary care hospital by the department of ophthalmology in association with department of Microbiology. Material & Methods: 350 patients above >20 years attending the OP of dept of ophthalmology with clinical signs and symptoms of dacrocystitis were enrolled. Demographic data, duration of illness, clinical signs and symptoms were noted. Specimens collected after lacrimal syringing or purulent material collected after applying pressure on the sac was transported to microbiology laboratory for processing and isolation of pathogens. The isolated pathogens were identified by standard biochemical tests and antibiogram interpreted by CLSI guidelines. Results: 350 cases were enrolled, with 196 acute and 154 chronic dacrocystitis. Females were predominant (54.3%) in the study and 3140 years was the predominant age group, with 39.4% having illness <1 week duration. 49.4% belong to low socioeconomic group and majority are house wives (22.9%) and farmers (32.3%). Epiphora was present in all cases of chronic dacrocystitis and pain and swelling was major complaint in acute dacrocystitis. Unilateral involvement in 89.4% of cases, right eye was most commonly involved in acute cases and left eye in chronic cases. Culture positivity was observed in 82% of cases, 297 total bacterial isolates and 14 cases were co infected with fungus Candida albicans. Staphylococcus aureus was the most common pathogen in the total study, Pseudomonas aeruginosa was the most common gram negative pathogen. Gram positive pathogens were predominant in acute cases and gram negative in chronic cases. All the isolates were sensitive to higher generation antibiotics. Conclusion: To conclude, our study clearly highlights changing trends of bacterial pathogens in causation of acute and chronic dacrocystitis. Tobramycin, Amikacin, netilmycin, imipenems are therapeutic options of choice in medical management of cases of dacrocystitis. The present study may help the ophthalmologist to choose appropriate rationale antibiotic which provides broader coverage of common ocular pathogens.

Keywords: Acute Dacrocystitis; Chronic Dacrocystitis; Epiphora; Staphylococcus Aureus; Pseudomonas Aeruginosa.