Eye diseases in cats. Diseases of the lacrimal apparatus

Dacryocystitis (Dacryocystitis). It's inflammation lacrimal bag. Pathology occurs in all animals, but more often in horses, dogs and cats. As a rule, dacryocystitis develops during the transition inflammatory process from neighboring mucous membranes (conjunctiva, nasal mucosa), from the neighboring periosteum or when foreign bodies are introduced into the lacrimal sac. Due to the narrowing and blockage of the lacrimal canal, the lacrimal fluid is retained in the lacrimal sac and under the influence of infectious agents decomposes.
Clinical signs. Inflamed mucosa lacrimal the sac swells, the secret, normally scanty, becomes profuse, often contains pus and mixes with stagnant tears. On examination, constant lacrimation, hyperemia and swelling of the conjunctiva are noted during inner corner eyes. A little lower, at the location lacrimal bag, show a slightly elastic, often slightly fluctuating swelling various sizes. When pressed on it, it stands out completely from the lacrimal openings. clear liquid, reminiscent of appearance egg white, mucopurulent or even purulent.
In other cases, there is no discharge from the lacrimal puncta, although it is felt that when pressed, the lacrimal sac is emptied. This indicates that the contents of the sac have entered the nasolacrimal canal, and from there into nasal cavity. If the lacrimal canal and the lacrimal openings are impassable, then the secret accumulates in the lacrimal sac, which sometimes reaches a considerable size. In the future, the wall of the bag is broken, the tissues of the wall are lysed and a fistula is formed. Palpation reveals pain, elevated temperature observed profuse lacrimation. Through the lacrimal openings, pus is released into the conjunctival sac and outward, which glues the eyelashes and the edges of the eyelids; crusts are formed. Partially purulent exudate released from the nasal cavity.
Inflammation lacrimal bag (especially purulent) has great importance in the pathogenesis of other eye diseases: the process can spread to the conjunctiva, and with minor violations of the corneal epithelium causes the development purulent keratitis and other complications. Therefore, any operations associated with opening the cornea are usually postponed until the treatment of dacryocystitis.
At differential diagnosis it is necessary to exclude neoplasms in the area of the bag, subcutaneous abscess and phlegmon of the surrounding tissue. The basis for the exclusion of tumors is the absence of lacrimation, if they do not compress the tear ducts; phlegmon and abscess - the absence of purulent discharge from the lacrimal openings.
Treatment. Recommended for small exudation conservative treatment. First of all, it is necessary to ensure the patency of the lacrimal canal so that the pus accumulated in the bag drains. To do this, the canal is washed through the nasal opening with disinfectants and slightly astringents. At the same time, it is useful to rinse the bag through the lacrimal openings.
To wash the canal, you can use solutions: furatsilina (l: 5000), silver nitrate (l: 5000), 2 ... 3% protargol, 1 ... 2% zinc sulfate, 1 ... 2% - th boric acid, penicillin (25,000 IU per 25 ml l% solution of novocaine), etc.
If conservative treatment fails, the lacrimal sac is excised. Since after excision of the bag, the wound heals according to secondary tension, then cicatricial obstruction of the outlet pathways may form. The operation cannot be considered radical, although after a while the lacrimation decreases. To completely stop lacrimation, after it is necessary to remove and lacrimal gland.
Removal lacrimal bag. After local anesthesia the skin, loose tissue and internal ligament are cut in layers along the convex part inward from the horseshoe angle palpebral fissure. Then the wall of the bag is grasped with tweezers and carefully bluntly dissected from the surrounding tissues. The preparation is greatly facilitated if, first, infiltration anesthesia with a 0.5% solution of novocaine is made around the circumference of the bag. The remaining junctions and lacrimal tubules are cut off with scissors. The operation is completed by suturing the wound.
Removal of the lacrimal gland. The operation is performed on a lying and securely fixed animal under local anesthesia. To extirpate the lacrimal gland, the skin is cut in layers (the length of the cut is from 4 to 6 cm) in the outer half of the lower top edge orbits, subcutaneous fascia and penetrate deep between the edge of the orbit and the aponeurosis of the elevator upper eyelid. The wound is expanded, the edge of the gland is grasped with wide tweezers and, slightly pulling, it is bluntly dissected from the surrounding orbital tissue. The wound cavity is plentifully powdered with Zhitnyuk powder, loosely filled with gauze, the edges of the wound are connected with provisional sutures. On the second day, several stitches are removed to remove the gauze. In the future, they are treated in an open way. Narrowing, blockage and infection of the lacrimal canal (Stenosis, obturatio et obiiteratio glanders lis nasolacrimalis). These anomalies, seen in all animals, may be congenital or may be the result of various pathological processes, both in the canal itself and in the surrounding tissues, for example, inflammation of the lacrimal canal or nasal mucosa, development of scar tissue in the area of the nasal opening, neoplasm, fracture of the lacrimal or maxillary bones, introduction of foreign bodies, helminths, plant awns from the side nose.
Clinical signs. The first and most noticeable signs are continuous lacrimation, maceration of the skin in the form of a strip in the region of the inner corner of the eye. With prolonged obstruction of the channel, inflammation may occur lacrimal sac and conjunctiva. In case of blockage of the lower opening of the channel above the place of narrowing, an expanded fluctuating section is revealed.
Congenital bilateral absence of nasal openings in three foals and one calf was observed by K. A. Fomin. The diagnosis was established by examination of the nasal cavity: cord-like soft protrusions of the mucosa were found above the normal location of the nasal openings of the lacrimal canal. Ugliness has been eliminated surgical intervention- in the area of protrusions, oval incisions were made in the mucosa to connect with the canal.
To clarify the diagnosis, the canal is probed with a soft catheter from the side of the lacrimal openings. By measuring the length of the catheter inserted into the channel, you can accurately determine the location of the obstruction. When probing from the side of the lacrimal openings, the catheter can be freely passed through the entire system and brought out through the nasal opening of the lacrimal canal. However, probing does not give a clear picture of the patency of the lacrimal canal. More objective method- tubular test. It consists in the fact that 2 ... 3 drops of a solution of neutral paint are instilled into the conjunctival sac, which, with normal patency, should penetrate into the nasal cavity in a few minutes. The most commonly used solution is fluorescein. Instead of fluorescein, you can use a solution of escorcin (red staining) or a 2 ... 3% solution of collargol (brown staining). If the solution does not appear in the nasal cavity, but overflows over the edge of the lower eyelid, then this indicates a mechanical obstruction of some of the sections of the lacrimal ducts.
For washing from the side of the nasal opening, a 20 ml syringe and a milk catheter are used. Previously, the nasal mucosa around the circumference of the opening of the lacrimal canal is lubricated with a 1% solution of novocaine. The syringe and cannula are connected with a rubber tube, filled with distilled water, the end of the catheter is inserted into the lacrimal canal and the solution is squeezed out of the syringe with a piston. The solution, under the pressure of the syringe, passes through the lacrimal canal into the bag and pours out with force through the lacrimal openings. Using this method, it is difficult to determine the degree of obstruction of the channel, since the force with which the solution is pushed out of the syringe will always be greater than the obstructing force in the channel. For example, the lacrimal canal for tear fluid is impassable (severe lacrimation is observed with catarrh of the nasal mucosa), while the solution injected through the nasal opening under pressure passes freely. Complete obstruction is due to obliteration of the canal on the basis of cicatricial contractions or blockage with stones.
With careless manipulations during the introduction of the catheter into the nasolacrimal canal, especially in restless animals, mechanical damage mucous, and with forced washing - microtrauma of the ciliated epithelium, which is fraught with serious complications. To avoid undesirable consequences and more objectively judge the patency of the canal, recommend next way washing. By connecting the syringe or funnel to the catheter through a rubber tube and filling the system isotonic saline sodium chloride, and, having also fixed the head of the animal well, the catheter is carefully inserted into the lacrimal canal, then the syringe is slowly raised to the level of the eye. It turns out a system of two communicating vessels. If the syringe is raised so that the liquid level in it becomes 1 ... 2 cm higher than the palpebral fissure, then in the case of patency of the lacrimal canal, the liquid flows freely through the lacrimal openings. There is no need to use a piston. At this method washing the epithelial layer of the lacrimal canal is not injured, and the results of the study will be more objective.
Treatment. With rhinitis, the nasal cavity is systematically irrigated with a 2% solution of protargol or boric acid, a 0.25% solution of potassium permanganate, a 0.3% solution of zinc sulfate. In horses and large cattle successfully apply probing with an elastic probe, followed by washing the lacrimal canal with a warm solution disinfectants. Neoplasms near the lacrimal opening are removed operational way.
With complete infection of the tear-nasal duct, the prognosis is unfavorable. Operational removal lacrimal gland cannot be counted effective measure, since tearing stops due to the fact that inflammatory and degenerative processes develop in the conjunctiva and cornea.

Inflammation of the lacrimal canal (Inflammatio canalis nasolacrimalis). catarrh of the nasolacrimal canal independent disease occurs very rarely. It usually occurs during the transition of the inflammatory process from the mucous membrane of the nasal cavity or lacrimal bag. The cause of inflammation can be dacryocystitis, often occurring simultaneously with catarrh, and much less often - secretion retention in the lacrimal canal or swelling of the nasal opening of the canal, which leads to stagnation and decomposition of the fluid, the development of the inflammatory process.
Clinical signs. are watching profuse flow only from the nasal opening of the lacrimal canal, the mucous membrane of the nasal cavity is not changed. If you run your finger along the channel in a downward direction, you can squeeze out a large number of secret. lacrimal sac remains unchanged. In animals on upper lip and drops of seromucosal exudate are visible in the nasal opening. The horse occasionally snorts, throwing out drops of mucus.
Treatment. Systematically wash the nasolacrimal canal with astringents antiseptics(see treatment for narrowing of the nasolacrimal canal).

There are a number of reasons why cats and dogs may have increased tear production. In all cases where tears flow beyond the edge of the eyelid, it is necessary to find out the cause of the problem and apply the appropriate treatment.

In this article, we will consider the causes of lacrimation, in which there are no changes in the eye.

Violation of the patency of the nasolacrimal canal

If the animal's eyes are constantly flowing and there are no symptoms of inflammation or other visible changes from the side of the eyes, a disruption in the functioning of the nasolacrimal canal is assumed due to a chronic inflammatory process, clogging of the canal or congenital pathology.

A cat or dog can be born with a congenital underdevelopment of the nasolacrimal duct, but in most cases, nasolacrimal occlusion occurs as a result of tissue scarring after past injuries or after a long illness eye infections. Also, blockage can occur as a result of getting into the nasolacrimal canal thick discharge, mud and sometimes grass seeds.

To diagnose canal occlusion, a veterinarian uses a fluorescein test. Before the test, the eye is thoroughly cleaned of secretions that can distort the result of the test. After that, fluorescein is instilled into the eye and after one or two minutes, with normal operation canal in the animal from the nose will appear green discharge. If the channel is partially impassable, the discharge will appear after five or more minutes in small amounts. With complete obstruction of the canal, there will be no discharge from the nose.

To correct obstruction of the nasolacrimal canal, lavage of the nasolacrimal canal or bougienage with nasolacrimal probes can be used to increase the lumen of the canal. These manipulations often normalize the activity of the nasolacrimal duct.

Obstruction of the nasolacrimal canal leads to the development of chronic inflammatory diseases of the mucous membrane of the eyes and inflammation of the eyelids. These diseases require permanent treatment with antibiotics and anti-inflammatory drugs. Drugs that reduce tearing are also used.

Tear streaks under the eyes

The flow of tears from the eyes is often accompanied by the appearance of brownish tracks under the lower eyelids. This often occurs in cats or dogs with short noses and bulging eyes and can develop in dog breeds such as the poodle, chihuahua, toy terrier, Yorkshire terrier, lap dog, shih tzu, and cat breeds of the Persian, British, Scottish, exotic, and other animal breeds.

The structure of the muzzle of such animals tends to cause narrowing of the nasolacrimal duct and lacrimal lake, and as a result, the tear almost constantly flows over the edge of the lower eyelid.

The application of treatment is carried out after finding out the cause of persistent lacrimation. If the problem is related to blockage of the channel, it is washed. If a congenital pathology is detected, then bougienage of the nasolacrimal canal can be performed in young animals.

Latent infections

Hidden infections, and most often chlamydial infections, cause profuse lacrimation in animals. In most cases, latent infections proceed without change. general condition organism. The animal is active a good appetite, and of the symptoms, only profuse lacrimation is observed, while the tear is completely transparent. To identify hidden infections the method of polymerase chain reaction (PCR) is carried out, which allows you to identify a specific infectious agent (DNA of bacteria, viruses, protozoa). If a specific pathogen is identified, a course of specific antibiotic therapy is used.

If you observe prolonged lacrimation in your pet, this symptom is a reason to contact veterinarian.

When tears flow from the eyes of a person, this is considered to be a sign of great excitement. In a cat, a similar phenomenon may indicate, for example, that sand or similar debris has entered the conjunctival cavity. But when tears flow in general incessantly, without stopping for a minute, this is an epiphora in cats.

This is the name of a pathology in which profuse and uncontrolled lacrimation caused by or blockage tear ducts(through the latter, excess tear fluid is removed into the nasal cavity), or by hypersecretion, when tears simply do not have time to leave through the “drainage”. But here it should be remembered that lacrimation is a natural response of the mammalian body to significant irritation of the mucous membrane of the eye. If an epiphora occurs, it does not need to be considered in terms of a separate pathology: it is just a symptom that may well indicate something more serious.

Moreover, even clinically healthy cats sometimes there may be spontaneous lacrimation. Most likely, this is due to a slight allergic reaction or getting dust in your eyes. But if such cases become permanent, and your pet's eye is constantly flowing, you need to take him to a veterinarian who can fully examine the animal. To better understand the meaning of the disease, you need to imagine a little physiological features normal eye.

The main reasons for the development of epiphora

In veterinary practice, most often one has to deal with a pathology that has developed under the influence of quite typical causes:

Unfortunately, these are not all the potential causes of the development of epiphora. Let's look at the predisposing factors in more detail:

when they begin to rub directly against the cornea. Constant irritation causes no less constant lacrimation. Pathology is very dangerous, without surgical intervention animal can .

Inflammation of the eyelids themselves (). The eyelids with this disease turn red, swell, feel hot to the touch.

(so called inflammation of the cornea).

Ulcerative lesions corneas, abrasions, wounds and other eye injury.

permanent exposure to the eyes of animal smoke, chemical aerosols, household detergents etc.

. Also extremely dangerous pathology. If the case is even slightly neglected, there is a risk of losing an eye.

Coming in veterinary clinic, pet owners often complain about profuse lacrimation in a pet. The reason for this may be epiphora.

Epiphora- this is a constant unregulated tearing (lacrimation), leading to the flow of tears along the buccal region with the formation of a lacrimal tract and staining of the coat in Brown color, sometimes with signs of dermatitis, hair loss around the eye and itching. At normal condition lacrimal organs tear production corresponds to tearing. Normally, up to 2 ml of tears are secreted per day.

The lacrimal organs are one of essential parts protective apparatus of the eye. They consist of a tear-producing apparatus and lacrimal ducts. The tear-producing apparatus is represented by a true lacrimal gland. Its secret is a transparent liquid of slightly alkaline reaction, which includes water - 99%, protein - about 0.1%, mineral salts- about 0.8%, as well as lysozyme, which has a bactericidal effect. In addition, it is also represented by Garder's lacrimal gland, which, unlike the true lacrimal gland, constantly secretes an oily fluid through the ducts and conjunctiva.

Tear ducts include:

lacrimal points facing eyeball, immersed in the lacrimal lake and leading to the lacrimal tubules;
lacrimal canaliculi (upper and lower), turned towards the nose and flowing each separately into upper part lacrimal sac;
lacrimal sac.

In order to identify a violation of lacrimation, you need to understand how the process proceeds normally. Along the tear ducts, there are a number of valves (flaps) that move the tear fluid in one direction - from the lacrimal lake to the nose (in cats, partially and in oral cavity). A tear from the glands enters the upper fornix of the conjunctiva. Due to gravity and as a result of the blinking movements of the eyelids, it flows into the lowest place of the palpebral fissure - the lacrimal lake, which is located at the inner corner of the palpebral fissure. From the lacrimal lake, the tear is absorbed by the lacrimal puncta, moving further along the lacrimal canaliculus to the lacrimal sac, then along the lacrimal canal into the nasal cavity, where it evaporates.

The following mechanisms for the development of epiphora are distinguished:

Increased production of tears as a result of irritation of the eye structure:

conjunctivitis;
inversion, eversion of the eyelids;
ectopic eyelash, which is a congenital pathology of the location of one, less often several hair follicles in the thickness of the conjunctiva of the upper or lower eyelid;
distichiasis - a pathology in which an additional row of eyelashes appears behind normally growing eyelashes. Tearing in dogs due to this pathology is typical for breeds such as bulldogs, Pekingese, poodles, yorkshire terriers, dachshunds, shelties;
trichiasis - abnormal growth of eyelashes towards the eyeball, irritating and corneal injury. Pathology is typical for dogs of Sheltie, Shih Tzu, Cocker Spaniel and Miniature Poodle breeds;
entropion - wrong position eyelid relative to the eyeball, in which the plane of the free edge of the eyelids, all or some of its part is turned inward. It occurs in Shar Pei and Chow Chow dogs;
ectropion - the position of the eyelid, in which it is partially or completely turned out;
eyelid agenesis - congenital absence or underdevelopment of the eyelids;
corneal ulcers;
entry of foreign bodies.

Violation of the patency of the lacrimal ducts:

congenital pathologies - the absence of the lacrimal opening, atresia of the nasolacrimal duct (overgrowth of the lacrimal openings). Most often found in dogs of the Cocker Spaniel and Golden Retriever breeds;
acquired - dacryocystitis (inflammation of the lacrimal sac, which develops due to narrowing of the lacrimal canal and delay in the outflow of lacrimal fluid from the cavity of the lacrimal sac), rhinitis, sinusitis, trauma, foreign body, tumors.

Imperfection of the lacrimal ducts:

too close to the eyeball, lower eyelid and shallow lacrimal lake in big-eyed or bug-eyed breeds. For example, in connection with this anatomical feature lacrimation often occurs in cats of Persian and similar breeds;
blockade of the lower lacrimal opening as a result of inversion of the inner part of the lower eyelid in brachycephalic breeds(Pekingese, pugs, French and english bulldogs, boxers, Persian and Himalayan cats). In other words, these are all animals that have a short muzzle, a flattened nose and a round head;
too much small size lacrimal point;
the hair on the internal lacrimal tubercle absorbs the tear, acting as a "wick" and causing the hair on the eyelids to become wet. AT this case epiphora occurs in cats, such as Persian, having long hair as well as in long-haired dog breeds.

Diagnostics

Lachrymation should be distinguished from lacrimal or purulent discharge from the eyes. When irritated, hyperemia of the eyes is observed. The acute onset of epiphora of one eye, accompanied by pain, occurs when a foreign object hits or when the cornea is injured. Chronic bilateral epiphora indicates a congenital pathology. With rhinitis and sinusitis, sneezing, nasal discharge are noted, with dacryocystitis - mucous or purulent discharge that accumulate in the inner corner of the eye.

To identify the problem, you can x-ray examination skull, which will detect the pathology of the nose and paranasal sinuses, prescribe CT and MRI. With dacryocystography (X-ray of the lacrimal ducts after they are filled contrast agent) determine the level and degree of lacrimal duct obstruction.

Perform a test with a dye (collargol). Normally, the substance is released from the nostrils 10 seconds after it is instilled into the eye. The canalicular test is also informative in clarifying the location of the obstruction. To do this, the cannula is inserted into the upper lacrimal opening. If the injected fluid does not flow from the lower point, then it can be assumed that there has been an obstruction of the upper or lower tubule, lacrimal sac, or complete absence lacrimal point. If the liquid has appeared from the lower lacrimal opening, then it should be closed with a hand, which will lead to the release of fluid from the nostrils, which is not observed with obstruction of the nasolacrimal duct.

In case of pathology of the nasal cavity or paranasal sinuses, rhinoscopy is performed with a biopsy of suspicious areas or taking a separated secret for bacteriological research. If the discharge is of purulent origin, then in without fail conduct a bacteriological examination before starting treatment.

Treatment

Treatment of epiphora is aimed at eliminating possible causes lacrimation. If it is conjunctivitis, keratitis (inflammation of the cornea, accompanied by its clouding and often decreased vision) or uveitis (inflammation choroid eyes), then appropriate treatment is carried out. When identifying foreign objects produce their removal. Until the final diagnosis is established, one should refrain from local use glucocorticoids. They are not prescribed even if the cornea accumulates a fluorescent dye.

With distichia, trichiosis, crevices of the eyelids and other anomalies, cryosurgery or electrolysis is used. When there is no lacrimal opening, it is formed surgical method. The same intervention is performed with cicatricial stenosis lacrimal opening after severe conjunctivitis (for example, herpetic). In case of stenosis and obliteration of the nasolacrimal duct, dacryocystorhinostomy is performed using various modifications, using external and internal approach. After the operation, the animal is under constant observation. In case of recurrence of the disease, a second operation is possible.

At inflammatory diseases until the results of bacteriological examination are obtained, antibiotic therapy is applied locally, with an interval of 4-6 hours. Treatment of dacryocystitis is based on bacteriological data and lasts at least 3 weeks (at least 7 days after the symptoms of the disease disappear). The animal is examined every 7 days. The lack of effect after 7-10 days of treatment makes it possible to suspect foreign body or hearth chronic infection. If dacryocystitis has chronic, then catheterization of the nasolacrimal duct is carried out to prevent its structure.
After the removal of the underlying cause, the epiphora usually disappears, but sometimes there are relapses, which should be warned by the owners of the animal.