Which procedure is NOT appropriate when evaluating a possible diagnosis of dacryocystitis?

The appropriate procedure when evaluating dacryocystitis involves different diagnostic methods that help in understanding the condition and its severity. Dilation and irrigation of the lacrimal system is not appropriate, particularly during the acute phase of dacryocystitis. This is because performing dilation and irrigation can exacerbate the infection or cause further trauma to the already inflamed and infected lacrimal sac.

In contrast, digital palpation of the medial canthal area can help assess tenderness or swelling, indicating the presence of infection. Exophthalmometry is useful in detecting any potential complications resulting in abnormal positioning of the globe, while Gram staining and blood agar cultures of the discharge provide critical microbiological information about the infectious organisms involved, guiding appropriate treatment. Thus, the procedure that could potentially worsen the patient's condition is correctly identified as not appropriate for evaluating dacryocystitis.