How to treat the lacrimal canal in an adult. Blockage of the lacrimal canal in newborns. Structure and main functions

Dacryocystitis in newborns accounts for 6-7% of all cases of eye diseases. Violation of the outflow of tears provokes stagnation and inflammation of the lacrimal sac (dacryocystitis), and then conjunctivitis, due to which parents do not notice the true cause of the disease. At the same time, they struggle with clinical consequences for months.

Persistent tears are common for a newborn baby. But if you began to notice the causeless from one or both eyes, after sleep, signs of inflammation or pus have joined, and the treatment you have chosen does not work, it may be time to reconsider the diagnosis.

Lacrimal duct obstruction occurs in all newborns. This is an anatomical feature of the development of the embryo. During the formation of the respiratory system in the womb, the lacrimal canal is closed by a thin epithelial septum (film), which protects the baby's respiratory system from amniotic fluid.

When the baby was born, he took air into his lungs and cried for the first time, the film breaks under pressure, freeing the patency of the lacrimal ducts.

Tears are produced in a gland located under the upper eyelid. It washes the entire eyeball and accumulates in the corners of the eyes near the nose. There are lacrimal openings - these are two openings behind which there are lacrimal canals, the upper one (absorbs 20%) and the lower one (80%). Through these tubules, tears flow into the lacrimal sac, and then into the nasal cavity.

A blockage, obstruction, stenosis, mucus plug, or just a narrow tear duct in a child that causes tears to become blocked and then become inflamed is called dacryocystitis.

There is congenital (primary) dacryocystitis in newborns, which manifests itself immediately after birth, and eventually disappears in children under one year old. And there is a secondary (acquired) dacryocystitis, it does not appear immediately, does not go away after a year or longer, is the result of blockage of the tubules after birth.

Tears are responsible for moisturizing the eye, nourishing the cornea, and contain dissolved immune complexes to fight bacteria that enter the eye from the air. Together with the lipid layer, the tear forms the eye film, which, in addition to protecting against drying out, reduces friction between the eyelid and the eyeball. Therefore, any narrowing or stenosis of the lacrimal canal disrupts the process of natural tear formation, natural circulation, which leads to complications.

Consequences of dacryocystitis in children:

purulent, infectious conjunctivitis;
decreased visual acuity;
phlegmon of the lacrimal sac;
the appearance of fistulas of the lacrimal sac;
development and generalization of infection.

Causes

The obstruction of the lacrimal canal in a newborn or infant is due to the absence of a rupture of the protective film that is given to us at birth. Or the presence of concomitant adhesions or mucous plugs, which the newborn could not get rid of with the first cry.

Causes of dacryocystitis in newborns:

anatomical underdevelopment of the lacrimal system;
excessive tortuosity or narrowing of the tubules;
anomaly in the location of the lacrimal sac;
curvature of the bones of the facial skull;
polyps, outgrowths, tumors that physically block the outflow.

Dacryocystitis in older children occurs as a result of trauma, physical damage, inflammation, or as a complication of a more serious disease.

Symptoms of the disease

Blockage of the lacrimal canal in children is often confused with the usual one, the wrong problem is treated for weeks. To distinguish conjunctivitis from dacryocystitis, you need to take a closer look at the newborn baby.

You may notice that periodically a newborn has a tear in one or both eyes for no apparent reason when the baby smiles. This suggests that the tear simply has nowhere to go, and the excess flows down the cheeks.
Next comes stagnation. Dirty tears that washed the eyeball accumulate in the sac, forming a "swamp". At this stage, the inflammatory process joins, we see redness, swelling, swelling, all signs of conjunctivitis.
At the next stage of dacryocystitis, the eyes of the newborn begin to turn sour, at first only after sleep, then constantly.
Then they appear, and when you press on the swelling in the projection of the lacrimal sac, pus flows out of it.
Over time, the process is aggravated, and antibacterial treatment gives only a temporary result.

Diagnostics

Dacryocystitis in newborns can only be accurately diagnosed by an ophthalmologist. At the first stage, if you suspect that the child's lacrimal canal is clogged, you can contact the pediatricians at the reception or the patronage nurse, and then you need to visit an ophthalmologist.

At the appointment, the doctor will examine the newborn, prescribe the necessary procedures, tests, and tests. With the help of a dye (collargol or fluorescein solution) and a West test, the presence of a blockage is checked. At the same time, drops with a dye are dripped into the eye and the time of their appearance is recorded, as well as the amount on a cotton swab in the nose.

Sometimes it is necessary to consult related specialists, examine an otolaryngologist for the structure of the nasal sinuses or septum. If necessary, ultrasound, computed tomography of the bones of the facial skull, laboratory tests are prescribed.

When inflammation is attached, a bacteriological sample of discharge from the eye is taken for flora and sensitivity to antibiotics.

Video: Health Handbook: Dacryocystitis

How to treat dacryocystitis in children

Neonatal dacryocystitis involves three treatment options:

conservative methods;
expectant tactics;
surgical intervention.

Which method of treatment is right for you, the doctor will determine when examining the newborn. Do not self-medicate or non-traditional folk methods. A newborn is not a field for experiments.

Conservative treatments for dacryocystitis include medication and massage. Combining these two methods can significantly speed up the healing process and alleviate the condition of the newborn baby.

Use drugs only in children's dosage and strictly follow the rules and massage technique.

Medical treatment

Obstruction of the nasolacrimal canal in babies is treated mainly with drops and ointments. The choice of an antibacterial agent should be based on the inoculation and sown microflora. Drops are instilled during the day and after the massage, and ointments are placed behind the lower eyelid at night. Dosage and method of application is prescribed by a doctor.

Drops and ointments from dacryocystitis for the treatment of newborns:

"Albucid".
Wigamox.
Infants are often prescribed "Tobrex".
"Levomycetin".
Gentamicin ointment.
Dexamethasone ointment.
"Oftakviks".
A solution of furacilin or chlorhexidine for washing, rubbing the eyes.

Drops before use must be heated to body temperature in the palm of your hand or in a water bath. Since it is necessary to store opened drugs in the refrigerator, it will be very unpleasant for the baby to instill cold medicines in the eye.

Video: Dacryocystitis or sour eyes in babies

Massage

How to pierce the lacrimal canal on your own without surgery? The main treatment for dacryocystitis in newborns is. The movements resemble pressure from the corner of the eye to the tip of the nose along the nasal septum. This physically pushes out any blockages and helps the tubules to clear.

Massage technique for newborns with dacryocystitis:

First of all, you need to wash your hands, remove all jewelry, cut your nails so as not to injure the newborn and not to infect.
If purulent discharge is present, first, with an upward movement, it is necessary to squeeze out the purulent contents. Wipe the eye with a cotton pad or gauze soaked in an antiseptic solution.
Then instill antibiotics in drops and now push the drops down the tubules into the lacrimal sac and beyond. Drops must be instilled several times.
Repeat these movements ten times, two or three times a day. Apply ointment to the lower eyelid at night.

Video: How to massage the lacrimal canal?

Operation

Surgery is the most radical way for dacryocystitis in young children and is used only if the previous methods have not worked. Then patency is restored surgically. The procedure takes place in a hospital, under local or general anesthesia.

If, after conservative treatment of dacryocystitis, the lacrimal canal in a newborn has not opened, apply:

Artificial puncture of the lacrimal canal in newborns.
Canal plasty with structural anomalies.
Bougienage, probing of the lacrimal canal.

The most popular is sounding. At the same time, a small thin probe is inserted into the opening of the lacrimal canal, which breaks through the plugs, breaks films, adhesions, and also expands the patency of the lacrimal ducts. The procedure takes several minutes, painless, but unpleasant for a newborn baby. In some cases, sounding is repeated after a couple of months.

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Obstruction of the lacrimal canal, according to medical statistics, is diagnosed in 5% of newborns. There is reason to believe that the pathology is much more common, just the problem may disappear before going to the doctor, without causing complications.

In all people, the normal surface of the eyeball is regularly wetted with tear fluid when blinking. It is produced by the lacrimal gland located under the upper eyelid, as well as additional conjunctival glands. This liquid forms a film that protects the eye from drying out and infection. Tears contain antibodies and biologically active components with high antibacterial activity. The fluid accumulates at the inner edge of the eye, after which it enters the lacrimal sac through special tubules, and from there it flows down the nasolacrimal canal into the nasal cavity.

Note:Since the baby cannot explain that he is experiencing discomfort, parents need to be able to recognize signs of the development of pathology.

Causes of obstruction of the lacrimal canal in newborns

While the baby is in the womb, the tear ducts are protected from amniotic fluid from entering them by a special membrane. Instead of a film, a plug may form in the canal, consisting of a mucous secretion and dead cells.

When a newborn takes his very first breath, this membrane usually ruptures (the gelatinous plug is pushed out), and the organs of vision begin to function normally. In some cases, the already unnecessary rudimentary film does not disappear, and the outflow of tear fluid is disturbed. When it stagnates and a bacterial infection attaches, a purulent inflammation of the lacrimal sac develops. This pathology is called "dacryocystitis".

Important:dacryocystitis of newborns is regarded by doctors as a borderline condition between a congenital anomaly and an acquired disease.

Quite often, parents are sure that the baby has developed conjunctivitis, and without prior consultation with the doctor, they begin to wash the baby's eyes with antiseptic solutions and apply eye drops with an antibacterial effect. These measures give a visible positive effect for a short time, after which the symptoms increase again. The problem returns, because the main cause of the pathology has not been eliminated.

Clinical signs of dacryocystitis and obstruction of the lacrimal canal in infants are:

Note:in most cases, unilateral obstruction of the lacrimal canal is diagnosed, but sometimes the pathology can affect both eyes of the newborn.

A characteristic symptom of this disease is the release of the mucous or purulent contents of the lacrimal sac into the conjunctival cavity with pressure in its projection.

Signs of the development of complications (progressive purulent inflammation) are restless behavior of the child, frequent crying and an increase in overall body temperature.

Complications of obstruction of the lacrimal canal in newborns

A complication of the pathological process can be stretching and dropsy of the lacrimal sac, accompanied by a well-marked local protrusion of soft tissues. The addition of a bacterial infection often causes purulent conjunctivitis. If adequate therapy is not started in a timely manner, the development of such a serious complication as phlegmon of the lacrimal sac is not excluded. In addition, if dacryocystitis is not treated, lacrimal sac fistulas may form.

The doctor diagnoses "obstruction of the lacrimal canal in a newborn" based on the anamnesis, a characteristic clinical picture and the results of additional studies.

To identify the obstruction of the lacrimal canals in infants, the so-called. collar head test (West test). The diagnostic procedure is carried out as follows: the doctor introduces thin cotton turundas into the external nasal passages of the child, and a harmless dye is instilled into the eyes - a 3% collargol solution (1 drop in each eye). The test is considered positive if after 10-15 minutes the cotton wool is stained. This means that the patency of the lacrimal ducts is normal. If there is no staining, then apparently the nasolacrimal canal is closed, and there is no outflow of fluid (West's test is negative).

Note:the collarhead test can be considered positive if, after 2-3 minutes after instillation of the dye, the baby's conjunctiva brightens.

This diagnostic procedure does not allow to objectively assess the severity of the pathology and the true cause of its development. With a negative test, it is imperative to show the baby to an ENT doctor. It will help determine if the cause of the outflow disorder is swelling of the nasal mucosa (for example, with a runny nose against the background of a common cold).

Important: differential diagnosis is carried out with conjunctivitis. A number of clinical manifestations of these diseases are similar to each other.

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Treatment of obstruction of the lacrimal canal in newborns

By the third week after birth, in many babies, the rudimentary film in the channels disappears on its own, due to which the problem is solved by itself.

Conservative treatment of blockage of the lacrimal canal

First of all, the baby is shown a local massage of the problem area (in the projection of the lacrimal canal). The procedure should be carried out by parents at home. Regular massaging helps to increase pressure in the nasolacrimal canal, which often contributes to the breakthrough of the rudimentary membrane and the restoration of the normal outflow of tear fluid.

Before doing a massage, you should cut your nails as short as possible to avoid accidental damage to the delicate skin of the newborn. Hands should be washed thoroughly with hot water and soap to prevent infection.

Pus is removed with a sterile cotton swab, abundantly moistened with an antiseptic - a decoction of chamomile, calendula or a solution of furacilin 1: 5000. The palpebral fissure must be cleaned of secretions in the direction from the outer edge to the inner.

After antiseptic treatment, they begin to carefully massage. It is necessary to perform 5-10 jerky movements with the index finger in the projection of the lacrimal canal. In the inner corner of the child's eye, you need to feel for the tubercle and determine its highest and farthest point from the nose. You need to press it, and then slide your finger from top to bottom to the baby's nose 5-10 times, without taking a break between movements.

How to cure a blockage of the lacrimal canal in newborns, says the pediatrician, Dr. Komarovsky:

Note:according to Dr. E. O. Komarovsky, in 99% of cases a positive effect can be achieved in a conservative way.

With pressure on the area of the lacrimal sac, a purulent discharge may appear in the conjunctiva. It must be carefully removed with a swab with an antiseptic and continue massaging. After the procedure, the baby should be instilled with antibacterial and anti-inflammatory drops (Vitabact or 0.25% Levomycetin solution) into the eyes.

Before starting treatment for obstruction of the lacrimal canal and prescribing antibacterial drops, it is advisable to conduct a bacteriological analysis of the discharge in order to identify the sensitivity (or resistance) of the pathogenic microflora that is the cause of the purulent process. It is undesirable to instill albucid into the eyes, since crystallization of the drug, which aggravates the course of the disease, is not excluded.

Manipulations are carried out 5-7 times a day for 2 or more weeks.

Often a child needs the help of a qualified ophthalmologist. If during the first six months of life it was not possible to restore in a conservative way, the rudimentary film becomes denser. It becomes much more difficult to eliminate it, and the risk of developing severe complications increases significantly.

Important:surgery on a child is usually performed at the age of 3.5 months.

The obstruction of the lacrimal canal and the ineffectiveness of massage procedures are an indication for surgical manipulation - probing (bougienage). This intervention is carried out on an outpatient basis (in an ophthalmology room, dressing room or small operating room) under local or general anesthesia. During treatment, the doctor leads a thin probe into the canal and carefully breaks through the pathological membrane. The total duration of manipulations is only a few minutes.

At the first stage, a short conical probe is inserted to expand the canal. The longer cylindrical Bowman probe is then used. It advances to the lacrimal bone, after which it turns in a perpendicular direction and goes down, mechanically removing the obstacle in the form of a film or cork. After removing the instrument, the canal is washed with an antiseptic solution. If the operation was successful, then the solution begins to pour out through the nose or enters the nasopharynx (in this case, the baby makes a reflex swallowing movement).

After such a radical intervention, in most cases, patency is quickly restored. Eye drops are also prescribed to prevent the formation of adhesions and the development of relapse. Shows the use of drugs, which include an antibacterial component and glucocorticoids; they allow you to stop swelling after the procedure. The child in the postoperative period is also shown a course of local massage.

If pus continues to be released 1.5-2 months after probing, then a second procedure is necessary.

A positive effect can be achieved in 90% of cases of diagnosed neonatal dacryocystitis.

The inefficiency of bougienage is an unconditional basis for an additional examination. In such cases, it is necessary to establish whether the violation of the patency of the lacrimal canal is the result of a curvature of the nasal septum or other anomalies in the development of the newborn.

If the pathology is not diagnosed in a timely manner or insufficiently adequate treatment was prescribed, then in the most severe cases, when the child reaches the age of 5, a rather complex planned operation is performed - dacryocystorhinostomy.

It is important to remember that constant lacrimation, and, moreover, the appearance of purulent discharge in the eyes of the baby, is a good reason for immediately seeking medical help. No need to try to self-diagnose and self-medicate in order to avoid serious complications.

Plisov Vladimir, medical commentator

The arsenal of therapeutic methods currently used in treatment includes a large number of pharmacological preparations. Also, in case of insufficient effectiveness of therapeutic agents, surgical methods for correcting dry eye syndrome are used, which are also based on moisturizing the eye.

The first operation in the treatment of dry eye syndrome was performed in 1951 by V.P. Filatov and V.E. Shevalev. The essence of this intervention was that the stenon duct of the parotid salivary gland was transplanted into the conjunctival cavity. The operation was accompanied by significant technical difficulties, high trauma, therefore, at present, it is practically not carried out. The artificial "crocodile tears syndrome" created in this way required a second operation to reduce the amount of salivary gland secretion. But recently, the operation of transplanting the duct of the minor salivary glands has become widespread.

A newer direction in the surgical treatment of patients with dry eye syndrome is the creation of a temporary or permanent obstruction to the outflow of fluid from the conjunctival cavity. Currently, this is solved by surgical and manipulation techniques.

A simpler and more common way to create an obstacle to the outflow of lacrimal fluid is obstruction of the lacrimal tubules. As a result of such an intervention, the native tear is retained in the conjunctival cavity, which improves the metabolism in the conjunctiva and. Studies have shown that two years after such an intervention, the number of goblet cells in the conjunctiva increases. Already in the first days after the intervention, the subjective symptoms of pathology are significantly reduced, and the stability of the tear film is also improved. Moreover, the obturation of the lacrimal ducts leads to the fact that the effect of instilled drugs is prolonged, which makes it possible to reduce the frequency of instillation of eye drops, and sometimes even stop them altogether.

An important problem of surgical methods for the treatment of dry eye syndrome is the lack of clear direct indications for lacrimal duct occlusion procedures currently missing. Of course, the operation is indicated for patients who have a significant decrease in the production of tear fluid (Schirmer's test is less than 5 mm / 5 min, Jones's test is 2 mm / 5 min and less), as well as those suffering from severe diseases of the cornea (ulceration, thinning, filamentous) - with such diseases, occlusion is performed with a Jones test result of 8 mm / 5 min and below, that is, with a slight decrease in the secretion of lacrimal fluid.

The procedure for occlusion of the lacrimal ducts or puncta requires control of the patency of the nasolacrimal duct. In case of its closure or in the presence of signs of chronic latent dacryocystitis, occlusion can cause the development of phlegmon of the lacrimal sac.

For the purpose of long-term obturation of the lacrimal ducts, gelatin and collagen implants, cyanoacrylate adhesives were initially used, but the effectiveness was not confirmed. Later, foreign ophthalmologists began to use rigid silicone plugs, which are inserted into the lacrimal canals with the help of special conductors.

Currently, the following models of long-term silicone lacrimal obturators are used:

Plugs-obturators of the lacrimal openings.
Lacrimal canal obturators.

Silicone plugs are inserted using special conductors. Further, each plug is fixed with an expanded working end in the ampulla of the lacrimal canal, with a constriction - in the stoma of the lacrimal punctum. The cork lid (its outer part) covers the lacrimal opening at the top. Such obturators are very easy to implant and, if necessary, removed. Their disadvantage is the possibility of traumatizing the tissue of the lacrimal punctum, cornea, conjunctiva with the cork cap. In this case, complications such as corneal erosion, granulomatous growths near the lacrimal papilla can develop. Also, the possibility of dislocation of the obturator inside the lacrimal canaliculus is not excluded, which can lead to rupture of its wall. Since this problem is very relevant, a special tool was developed to perform the extraction and reposition of the obturators.

After blocking the lacrimal canaliculus or lacrimal puncta, all patients experience severe tearing, sometimes. Patients should be warned about this side effect in advance.

In order to evaluate the effectiveness of long-term obturation of the lacrimal ducts, it is initially advisable to introduce collagen plugs into the lacrimal canaliculi, which dissolve on their own after 4-7 days. If a positive effect is obtained during the period of their stay in the lacrimal ducts, then a long-term obturation with silicone plugs is already carried out in the future.

To date, there are surgical techniques for obstructing the lacrimal ducts. The most minimally traumatic and effective method is the overlap of the lacrimal opening with the conjunctiva. During surgery, a free conjunctival flap is taken from the bulbar region. This intervention is highly effective in Sjögren's syndrome.

The cost of the operation of obturation of the lacrimal ducts

The cost of the lacrimal canaliculus obturation surgery for dry eye syndrome differs depending on the clinic, the qualifications of the ophthalmic surgeon, and the volume of intervention.

The main reason for the obstruction of the lacrimal canal in newborns is congenital disorders of the structure of the organs of vision, in which the eye canal does not open in a timely manner. As a result, the baby has a stagnation of tears, a bacterial infection, accompanied by pathological symptoms, may join. If the diagnosis is determined in time, the treatment is conservative. When the blockage could not be eliminated with medication, and the canal remained closed, a surgical operation is performed to eliminate the stenosis of the nasolacrimal canal.

Main reasons

While the baby is in the womb, its lacrimal canal is closed with a specific film that protects the organs of vision from the fluid surrounding the fetus. Immediately after the baby is born, the nasolacrimal ducts open, and the membrane that is in them comes out. But in individual cases, the ducts remain closed or their partial blockage occurs. Then the diagnosis of "obstruction of the lacrimal canal" is made, which must be started to be treated as soon as possible.

In an older infant, narrowing of the nasolacrimal duct can occur with disorders such as:

infection of the organs of vision;
nose and eye injuries;
improper formation of the nasal bone;
neoplasms in the nose.

You can understand that babies have clogged tear ducts by the characteristic symptoms. A child at this age is not able to explain what worries him. If the eye does not look the same as always, and accompanying signs appear, you should not wash the blockage yourself and try to cope with the problem on your own. Often improvements come, but they are short-lived. The symptoms return again and, if the duct is not opened, complications develop that are much more difficult to cure. Sometimes the structure of the visual system can be disrupted due to intrauterine developmental anomalies. Then the tear ducts in the baby will be completely absent. This disorder is called atresia. It is important to distinguish it from stenosis because the treatment here is different.

What symptoms are of concern?

Eye pathology in a baby can manifest itself as increased capriciousness.

If a child's tear duct is clogged, symptoms may not bother you at first. But after a while, the disease begins to make itself felt. Often the inflammation is localized in one eye, but sometimes the disease affects both organs. Infants and older children become capricious, irritated, behave unusually. There are also symptoms such as:

Increased tearing. The eyes are watery all the time, the baby looks tired, tearful.
Purulent discharge. Blockage of the lacrimal duct is almost always accompanied by the addition of a bacterial infection. As a result, the eye is constantly festering, pus accumulates in the space between the eyelashes, which is why in the morning the kids open their eyes with difficulty.
Inflammation, swelling and redness of the eyelid and eyeball. With a clogged nasolacrimal canal, the fluid does not circulate normally, but stagnates. As a result, infection occurs. When pressing on the inflamed area, the child becomes sick.
Failure of symptomatic treatment. Antibacterial drops help for a short time, as they only eliminate the symptoms, but do not break through the clogged tubule. If it has not opened, pathological signs quickly return.

Often in children under one year old, stenosis of the lacrimal canal resolves without special treatment. But if by this age the ducts have not opened or clogged even more, a surgical cleaning of the paths is carried out, with the help of which it will be possible to get rid of the pathology.
Possible Complications

If pathogenic bacteria get into the clogged duct, then the baby may develop purulent conjunctivitis.
If the lacrimal canal in newborns is not open or too narrow, due to the accumulation of pathological fluid, the lacrimal sac is overstretched, which becomes well visible during visual examination. Soon there is an attachment of a bacterial infection, as a result of which chronic purulent conjunctivitis progresses in the child. If you do not clean the clogged lacrimal sac and do not treat the disease, the risk of cellulitis increases, which can cause brain abscess and sepsis.

Diagnostics
If a child has a clogged nasolacrimal canal, he will begin to be disturbed by characteristic signs that cannot be overlooked. In this case, self-medication is contraindicated, since the closed ducts become inflamed, and the risk of developing life-threatening complications increases, so you cannot do without a visit to the doctor. The disease will be treated by a pediatric ophthalmologist, it is to him that the first appointment is made. The doctor will conduct a physical examination, palpation, ask about disturbing symptoms, and collect all the data. To prescribe an effective treatment regimen, the doctor gives a referral for a number of additional diagnostic procedures, such as: A child's sore eye can be treated with Levomycetin drops.
Obstruction of the nasolacrimal canal is accompanied by inflammation and the release of purulent exudate from the lacrimal sac. To speed up recovery, the eyes are cleaned with a special antiseptic solution of the drug "Furacilin". For the procedure, it is recommended to use cotton circles, because the villi can separate from the gauze or bandage, and if the eyes of the crumbs are open, these individual villi can penetrate under the eyelids and cause additional discomfort. If conjunctivitis has joined, antibiotics can not be dispensed with. Eye drops such as:
"Levomitsetin";
"Dexamethasone";
"Oftadek".

Self-medication and replacement of drugs without the knowledge of a doctor are unacceptable. If you violate the therapy regimen, the disease cannot be cured, and then complications cannot be avoided.

Dacryocystitis is a condition where the outflow of tears cannot occur naturally for various reasons, causing the eye to become inflamed. The main cause of this inflammation is the obstruction of the lacrimal canal. We will understand why this happens if we consider the anatomy of the eye.

The lacrimal gland produces tears in portions, which, washing the eye, drain to the inner corner, where the upper and lower lacrimal points are located. Passing through them, the tear enters the lacrimal duct, and then into the lacrimal sac. Further, the journey continues along the lacrimal canal directly into the nasal cavity.

But sometimes there is no break. The resulting tears have to look for workarounds or be in a state of stagnation. Blockage of the tear duct leads to the accumulation of fluid in the sac, it is clogged, swells, inflamed and becomes fertile ground for infections that love heat and moisture.

A similar problem occurs in 2-4% of infants. In order to effectively and as soon as possible help the baby get rid of it, it is important to know how this condition manifests itself, as well as what are the basic principles of its treatment.

Pathogenesis

Tears are synthesized by the lacrimal gland. After washing the anterior surface of the eyeball with tear fluid, the tear is directed to the medial corner of the eye. Through the lacrimal openings and tubules, it enters the common lacrimal canal and the sac, which passes into the nasolacrimal canal. The tear duct opens under the inferior nasal concha.

With obstruction of the nasolacrimal canal, the outflow of tears is impossible. This leads to the fact that all the above structures are overflowing with tear fluid. Prolonged stasis aggravates obstruction, promotes the secondary formation of calculi from inorganic substances that make up tears (sodium chloride, sodium and magnesium carbonate, calcium).

Causes of dacryocystitis in adults

Dacryocystitis occurs in the presence of pathologies of a physiological nature, namely, congenital narrowing of the duct (stenosis). Sometimes doctors reveal a complete blockage of the lacrimal duct.

The main causes of the disease:

Injury to the eyes or paranasal sinuses.
Inflammatory process of the nose, which provokes swelling of the tissues around the eye.
An infectious process caused by bacteria and viruses, which leads to clogging of the duct.
Contact with foreign particles in the eye or work in dusty and smoky rooms. As a result, the channel becomes clogged.
Allergy to an irritant.
Reducing the protective properties of the body.
Overheating and hypothermia.
The presence of diabetes.

Very often this pathology occurs in newborn babies. This is due to the peculiarity of the structure of the lacrimal ducts. When the baby is in the amniotic fluid, the tear duct is closed by a special membrane that must rupture during or after childbirth. This process does not occur if pathology occurs.

Tears collect in the canal and this provokes an inflammatory process. It mainly develops in women. Men are also no exception, but they rarely have this pathology. The reason is the differences in the structure of the lacrimal canal. Women use cosmetics, most of which cause inflammation.

In the region of the lower eyelid, at the inner corner of the eye, there is a lacrimal opening - a hole less than a millimeter in diameter. A tear flows down her. This mechanism is very interestingly thought out by nature: the pressure in the lacrimal sac is always negative, due to this, the eye fluid is sucked out. Through the lacrimal opening, the fluid passes into the lacrimal canal, and from there it can freely flow into the nose.

As a rule, inflammation of the channel caused by obstruction occurs either in infants or in old age. In newborns, the cause of obstruction is the fusion of the lacrimal canal. The fact is that in a child in the womb, a special membrane is formed in this channel, which must be torn by the time of birth. Therefore, most often, a pathological lacrimal canal occurs in premature babies.

congenital obstruction of the lacrimal canal,

damage,

infectious ophthalmic diseases and complications after such diseases.

The disease is very common in newborns. Often the initial underdevelopment of the lacrimal canals or secondary infection leads to inflammation. In any case, this problem is solved with the growth of the child.

Causes of inflammation in adults

In an adult, such a disease occurs most often after an injury, or after an inflammatory disease in the nasal cavity, as a complication. But in most cases, the cause of inflammation is not established.

In the elderly, the symptoms of the disease are caused by atherosclerosis of the vessels, in particular those responsible for tears. Insidious cholesterol can be deposited even in the openings of the lacrimal ducts, already tiny. In this case, the lacrimal ducts are expanded by washing with various solutions under pressure, for example, furacilin.

There is an inflammatory process of the lacrimal canal in middle-aged people. The reason is a congenital abnormality. In this case, the patient usually complains that in the cold season a tear constantly runs from one eye. This is due to the fact that any person in the wind and cold has a spasm of the lacrimal duct, and if it is initially narrowed, then the poor fellow simply bursts into tears.

To protect your eyes from frost, a patient with symptoms of inflammation can use ordinary glasses. The fact is that under the glasses of the glasses there is an almost greenhouse environment, the temperature of which is much higher than the ambient temperature. It has long been noticed that among bespectacled people there are practically no people with obstruction of the lacrimal canal.

1. Severe hypothermia, or vice versa, overheating of a person.

2. The presence of severe chronic diseases, especially diabetes.

3. Violation of the general metabolism in the body.

4. A sharp decrease in immunity.

5. Contact of various microorganisms and infections in the eye.

6. The presence of untreated inflammation in the sinuses, which provoke swelling of the tissues located in the area around the eyes.

7. Previous eye injury.

8. Getting a foreign object (hair, midges, villi, etc.) into the eyes.

9. Long stay in rooms with dust.

10. Contact with the shell of the eye of various irritating vapors.

In addition, this disease is very often detected in newborn babies. This is due primarily to the fact that infants have certain features of the physiological development of the lacrimal canals, due to which they are more susceptible to the development of dacryocystitis.

The fact is that when the fetus stays in the womb, its lacrimal canals are covered with a protective membrane. If the child has some pathologies, then this membrane can be preserved even after birth. This will lead to the accumulation of lacrimal secretions in the infant and provoke the development of pathogenic microflora.

As for adults, they also have this disease, but it is much less common. Moreover, it is known that women are more susceptible to dacryocystitis than men. The reason for this is the peculiarities of the general construction of lacrimal functions in the female.

Also, women are more likely to have inflamed eyes because they use various cosmetics on their eyes, which can also provoke their inflammation.

Sinusitis and tonsillitis, not treated on time, often cause damage to the lacrimal canal in adults. In addition, the disease can occur due to:

fracture of the nasal septum;
damage to the wall of the nasolacrimal canal;
the presence of polyps;
clogging of the eyes with chemicals, foreign objects;
allergies;
weakening of the immune system;
violations of the metabolic process;
diabetes mellitus.

While the baby is in the womb, the tear ducts are protected from amniotic fluid from entering them by a special membrane. Instead of a film, a plug may form in the canal, consisting of a mucous secretion and dead cells.

Important: neonatal dacryocystitis is regarded by doctors as a borderline condition between a congenital anomaly and an acquired disease.

Our tear fluid is secreted from the tear glands located above each eye. Tears flow down the surface of the eye, moisturizing and protecting it. The tear fluid then seeps into thin holes in the corners of the eyelids. The "waste" tear fluid through special channels enters the nasal cavity, where it is reabsorbed or excreted.

Blockage of the lacrimal canal at any point in this complex system leads to disruption of the outflow of tear fluid. When this happens, the patient's eyes water and the risk of infection and inflammation increases.

Congenital obstruction. In some children, the drainage system may be underdeveloped. Often the lacrimal canal is clogged with a thin mucous plug. This defect may disappear on its own in the first months of life, but may require a special procedure - bougienage (probing).

Abnormal development of the skull and face. The presence of abnormalities, such as in Down's syndrome, increases the risk of obstruction of the lacrimal ducts.

Age changes. Older people may experience age-related changes associated with the narrowing of the openings of the tear ducts.

Infections and inflammation of the eyes. Chronic inflammation of the eyes, nose, and tear ducts leads to obstruction.

Facial trauma. In a facial injury, the bones near the tear ducts can be damaged, which disrupts the normal outflow.

Tumors of the nose, lacrimal sac, bones, with a significant increase, sometimes block the lacrimal canals.

Cysts and stones. Sometimes cysts and stones form within this complex drainage system, causing obstruction of the outflow.

External medicines. In rare cases, the use of eye drops (for example, to treat glaucoma) can cause tear ducts to become blocked.

internal medicines. Obstruction is one of the possible side effects of the drug docetaxel (Taxoret), used to treat breast or lung cancer.

Risk factors

Age and gender. Older women are more likely to suffer from this disease as a result of age-related changes.

Chronic inflammation of the eyes. If the eyes are constantly irritated and inflamed (conjunctivitis), there is an increased risk.

Surgical operations in the past. Operations on the eye, eyelid, sinuses can cause scarring in the drainage system of the eye.

Glaucoma. Anti-glaucoma drugs sometimes contribute to the development of obstruction of the lacrimal ducts.

Cancer treatment in the past. If a person has been exposed to facial radiation or taken certain anticancer drugs, the risk is increased.

Risk factors

In adults, dacryocystitis occurs due to narrowing and closing of the nasolacrimal canal. Due to the narrowing of the channels, the circulation of the fluid is disturbed. As a result of this, stagnation of the lacrimal secret occurs, in which microorganisms begin to actively develop.

Congenital obstruction. Too dense mucous membrane blocks the drainage system. It can resolve on its own during the first months of life. If this does not happen, resort to bougienage.
Accession of an infection. Any stagnation of liquid in a warm place is a breeding ground for bacteria. This is how inflammation of the nasolacrimal canal (dacryocystitis) develops.
Pathological formation and growth of the nasal bone presses on the tear duct and can block it.
Tumors of the nose, face; the presence of cysts or stones in the duct.

Classification

● Congenital. With this form, obturation of the canal occurs in its lower part. Dacryolites have a soft texture. The disease is diagnosed in the neonatal period.

● Purchased. The overlap of the lumen of the duct is possible in any part, but most often the channel is affected in the upper sections. The consistency of stones is dense. Self-healing is almost impossible.

Irrigation of the lacrimal canal in adults

In adults, obstruction of the lacrimal canals can be detected at any age, but the procedure is often purely diagnostic in nature: in this way, passive patency of the lacrimal ducts can be established, and if necessary, expansion of the canals can be achieved by repeated washing.

In adults, problems with patency are eliminated worse, and massage in this case will not help.

Probing will not help either, since the densely formed tissues will again assume the same state, and the only way out is to make a series of washes.

If the obstruction occurs due to the film that has appeared, the procedure is meaningless: surgical intervention is required, during which it is excised.

Antibiotic drugs can be given as eye drops or nasal sprays.

These funds will help not only to avoid the development of foci of pathogenic microflora, but after surgery they will eliminate the manifested inflammatory processes.

Before starting treatment, it is necessary to determine the presence of this disease. To do this, you need to consult an ophthalmologist. The doctor, by examination, will be able to identify the disease, determine the degree of obstruction of the fluid of the lacrimal system, its localization (after all, without an examination it is difficult to determine exactly where the narrowing of the lacrimal canal occurred). Based on the results of all actions, the specialist will prescribe the necessary treatment.

Dacryocystitis in adults is usually treated with surgery. The choice of operation depends on the neglect of the disease. With a mild form of the disease, it is also possible to use massage. Let's look at all types of treatment.

Symptoms of obstruction of the nasolacrimal canal

Tears are necessary for the normal functioning of the organs of vision. They moisturize the cornea of the eye, protect against mechanical irritants, perform an antibacterial function.

Sometimes tears stop flowing, this is the first sign of an obstruction of the tear duct. Treatment is one of the ways to cope with the problem and prevent the development of canaliculitis. Sometimes lacrimal canal massage helps.

Main symptoms:

pain and discomfort in the eye area;
redness of the skin around the eye;
feeling of squeezing and bursting;
swelling of the skin;
lacrimation;
edema;
vision problems;
increased secretion of mucus that smells bad;
the formation of pus;
high body temperature;
body intoxication.

The acute stage of dacryocystitis appears as an inflammatory process affecting one eye. In the chronic stage, the lacrimal canal swells, the eye turns red and the number of tears increases.

Usually, the treatment and symptoms of inflammation of the tear duct are observed in only one eye.

There is very strong tearing

In the region of the inner corner of the eye, pain is felt, redness and swelling occur.

Allocations are also important signs of the disease.

During the diagnosis, the doctor examines the lacrimal ducts, assesses the degree of development of the process and examines the patient to detect additional concomitant pathology.

There are two forms of inflammation of the lacrimal canal: acute and chronic. Each of them is accompanied by characteristic symptoms.

1. Development of puffiness in the area of the inflamed eye.

2. Pain on palpation of tissues near the eye.

3. The appearance of severe swelling in the area of the lacrimal sac.

4. Strong narrowing of the palpebral fissure, which makes it difficult for a person to see.

5. Redness of the lacrimal duct.

6. Loss of ability to work.

7. Quick fatigue.

8. Dizziness.

9. Blue tissue.

10. Increased blood pressure (in adults).

11. Thickening of tissues near the eye.

12. The formation of an abscess at the site of swelling.

13. Loss of appetite.

14. Aching pain in the eye.

1. Constant tearing.

2. The appearance of purulent discharge in the area where the abscess formed.

3. Edema of the eyelids.

4. Pain when blinking.

5. Severe pain.

6. Headache.

7. Sleep disturbance.

8. Irritability.

9. Loss of elasticity of the skin under the eye (it can become thin, sluggish and stretch easily).

In newborn babies, this disease can be detected by the presence of small purulent discharge and swelling on the eyelids. If this condition is not cured, then the child will have constant tearing of the eyes.

1. Phlegmon is one of the most dangerous complications of this condition. Phlegmon can not always open outward. Moreover, if pus breaks into the inside of the patient's tissues, it will penetrate into the lacrimal canals and may even seep into the skull. This will cause severe infection.

2. Due to the penetration of pus into the tissues, the patient can not only have a fever, but also worsen memory and develop malfunctions in the nervous system.

3. A person can lose sight and consciousness.

Such complications can develop only in the absence of timely treatment and postponing a trip to the doctor. If you visit the doctor already at the first signs of the disease, then negative consequences can be avoided.

Symptoms of the early stage of dacryocystitis are mild. The patient does not feel pain, only a feeling of fullness under the eyes. Swelling may occur.

Later, the patient is uncomfortable with the appearance of tears and a feeling of mild pain. If you press on the rounded area of the lacrimal sac, you can notice purulent discharge.

They are accompanied by increased lacrimation, which leads to reddening of the skin in the area of inflammation.

Symptoms of the acute stage of the disease are more pronounced. The eyelids become swollen, the palpebral fissure closes, and the affected area turns red. The edema extends to the cheek. Patients feel chills, throbbing pain. They are worried about headaches, feverish conditions. At this stage of the disease, the purulent capsule opens itself (not in every case), the purulent fluid flows out.

In place of the capsule, phlegmon (purulent inflammation of the cell space) is often formed. For a pathology that develops in this way, frequent relapses are characteristic. They are accompanied by the release of pus, tears, sticking of eyelashes in the morning, after a night's rest.

Important! Neglect threatens the development of an abscess or, even worse, sepsis. The latter means complete blindness. But there is an opportunity to avoid the consequences - contact the doctors as soon as possible.

Please note: in most cases, one-sided obstruction of the lacrimal canal is diagnosed, but sometimes the pathology can affect both eyes of the newborn.

A characteristic symptom of this disease is the release of the mucous or purulent contents of the lacrimal sac into the conjunctival cavity with pressure in its projection.

Signs of the development of complications (progressive purulent inflammation) are restless behavior of the child, frequent crying and an increase in overall body temperature.

Obstruction of the lacrimal canal can be observed either from one eye or from both sides.

Too much tear fluid (moist eyes).
Frequent inflammation of the eye (conjunctivitis).
Inflammation of the lacrimal sac (dacryocystitis).
Painful swelling in the inner corner of the eye.
Mucous or purulent discharge from the eye.
Blood in tear fluid.
Blurred vision.

In the acute form of the disease, clinical symptoms are most pronounced. In the area of inflammation of the lacrimal canals, a sharp reddening of the skin and painful swelling occur. The palpebral fissures due to edema of the eyelid are greatly narrowed or completely closed. The patient may experience pain in the eye area, chills, fever, headache.

The chronic form of the disease is characterized by constant lacrimation and swelling in the area of the lacrimal sac. When pressing on this area, mucopurulent exudate is released from the lacrimal canals. In the area of the lacrimal sac, a swollen neoplasm is formed, visually resembling beans. As it develops, it becomes densely elastic.

After the pathogen enters the lacrimal canal, the process of inflammation, edema and disruption of the outflow of tear fluid begins. If no measures are taken, the disease will not disappear, but suppuration will intensify and even the development of phlegmon is possible. In this case, the treatment will be only surgical.

You can suspect dacryocystitis by the following symptoms:

Feeling of fullness in the inner corner of the eye and along the projection of the lacrimal canal;
Swelling of the inner corner of the eye;
Lachrymation;
Purulent discharge from the affected eye;
When pressing on the eye, pus begins to come out of the lacrimal opening.

Dacryocystitis occurs in newborns, children and adults of all ages. In newborns, it is sometimes bilateral in nature, however, the anomaly of the lacrimal canal is not detected immediately from the moment of birth, but after a few weeks. The time of appearance of the first signs directly depends on the degree of narrowing or blockage of the canal.

Normally, babies begin to cry with the release of tear fluid only at 3-4 weeks from the moment of birth, but this does not mean that they do not produce fluid. It stands out a small amount, which is enough to moisturize the eye. When the lumen of the lacrimal canal narrows, parents notice that the baby has a constant tear in the eye, sometimes rolling down the face. The skin around the eyes gradually macerates, becomes edematous, hyperemic, dermatitis develops.

With suppuration of the lacrimal sac and the development of phlegmon, the main danger lies in the transition of the infection to the cornea of \u200b\u200bthe eye. In this case, ulcers and erosion occur, deeper layers of the eyeball are captured and a threat to the child's vision appears.

The initial phase of the development of dacryocystitis is in many ways similar to acute conjunctivitis, but they can be distinguished from each other by a number of characteristic symptoms. If an eye disease begins in a newborn, then it mainly develops against the background of a viral or microbial infection that entered the child's body during childbirth from an infected mother, or in the first days of a baby's life with improper care.

In acute conjunctivitis, in addition to other symptoms, there is always redness of the eyes, while this is uncharacteristic for dacryocystitis. In addition, conjunctivitis predominantly affects both eyes, especially infection during childbirth. Dacryocystitis in babies can be observed in both eyes at the same time, but this is not so common, basically the process occurs only in one eye.

With congenital pathology, the first symptoms are detected even in the neonatal period. Parents note involuntary tearing in the child. The symptom of a "wet" eye is determined. If the cause of the disorder is amniotic fluid embolism or mucosal obstruction, gentle massaging of the duct contributes to complete regression of clinical symptoms.

Inflammation of the lacrimal canal: methods of treatment and diagnosis

Dacryocystitis is detected without much difficulty. At the appointment, the doctor conducts a visual assessment of the eye and palpation of the lacrimal sac.

Additional activities:

Paint test. The eye is instilled with a dye solution. If pigment appears in the eye after a few minutes, this indicates a blockage of the lacrimal canals.
Sounding. Using a probe with a needle, the ophthalmologist is introduced into the duct, which contributes to its expansion and getting rid of the problem.
Dacryocystography. X-ray examination with the introduction of a dye. In the picture, you can see the structure of the eye system and identify the problem.
Patency can also be checked with a West test. A cotton swab is placed in the nasal passage, from the side of the lesion. Collargol is instilled into the eye. The state is considered normal when, after 2 minutes, the tampon turns dark. If the tampon remains clean or stains after 10 minutes, there is a problem.

1. Smear for detection and differentiation of bacteria.

2. Rhinoscopy.

3. Diagnosis of the patient's eye under a microscope.

4. The introduction of a special dye into the eye for radiography.

1. The severity of the disease.

2. The patient's condition and the presence of complications.

3. The presence of concomitant diseases in the patient.

4. Reasons for the development of pathology.

5. Age of the patient.

1. Washing the eye canals with special disinfectant solutions.

2. The use of drops and ointments with an antibacterial therapeutic effect. Usually, drugs are prescribed for this purpose: Floxal, Dexamethasone, Lefomycetin and Ciprofloxacin.

1. Bougienage. This operation is aimed at cleansing the lacrimal canals from accumulated pus.

After bougienage, the lacrimal fluid will no longer stagnate and the overall patency of the ducts of the eye will be restored. In addition, this method is often used when the patient has chronic dacryocystitis and often has exacerbations of the disease.

2. Dacryocystomy is an operation that consists in forming a valve in the lacrimal canal. Thanks to this procedure, pus will stop accumulating.

1. When the first signs of illness appear in the baby, it is very important not to self-medicate the child, but to immediately show it to the doctor.

2. Usually, after diagnosing dacryocystitis in babies, they are prescribed special therapy, which includes massage.

Lacrimal duct massage is an important part of the treatment of this disease in infants. The main ban on its implementation is the most neglected form of the disease, in which the baby already has abundant purulent discharge and other complications. In this state, massage cannot be done, since there is a risk of pus leaking into soft tissues, and this threatens to infect the blood.

1. First, the mother should wash her hands well with soap and rinse them in an antiseptic solution. You can also do massage in medical gloves.

2. After that, you need to carefully squeeze out the ichor and pus that has collected in the baby's eyes. To do this, use a clean cotton swab, previously moistened with furacilin.

3. Only after that you can start the massage itself. The best time for it is the period before feeding.

4. Massage is done four times a day. In this case, you need to make light circular movements on the sore eye of the child and try to push the pus out of it.

5. It is very important not to press too hard on the lacrimal sac, as this can push the membrane inward, which will only worsen the baby's condition.

6. After the massage, wipe the eye well with a cotton pad soaked in an antibacterial solution.

Instead of medicinal solutions, it is also allowed to use homemade decoctions of chamomile, which has an antibacterial effect.

It is important to know that if the traditional treatment of this disease did not give the expected results, then probing is prescribed for the child. This procedure consists in introducing a probe into the lacrimal canal of the child, which will pierce the membrane that caused the appearance of dacryocystitis. Such an operation is always done under local anesthesia, so the baby will not feel pain.

After probing, the eyes will be washed with therapeutic solutions against the development of microbes and inflammation.

The effectiveness of this procedure is very high only in the first two months of a baby's life. The result after its implementation is noticeable almost immediately - the child will no longer have constant tearing and swelling of the eyes.

1. The use of aloe juice gives a very good effect. To do this, the juice must be diluted in half in warm water and used to apply compresses to the eyes. You need to repeat this procedure two to three times a day.

2. The use of thyme, which has a pronounced anti-inflammatory effect, also bring results. To do this, thyme must be steamed and insisted for several hours. Strain the prepared broth and rinse your eyes with it three times a day.

Before using traditional medicine recipes, you must always consult a doctor.

For the prevention of dacryocystitis in adults, it is necessary in every possible way to protect the eyes from irritation, maintain immunity and avoid hypothermia.

As for children, unfortunately, newborns cannot be saved from the development of inflammation of the lacrimal canal, since this occurs for purely physiological reasons.

Dacryocystitis has a characteristic symptomatology, due to which the diagnosis does not cause difficulties for doctors. Examination of the patient begins with palpation of the lacrimal sac. It is needed to detect the presence of a purulent secret.

The West test is the next step. What is its essence? The technique is carried out according to the scheme: medical solutions (protargol, collargol) are injected into the patient's conjunctiva.

At the same time, a turunda is inserted into the nasal sinus. The injected drug should stain the tear ducts within five minutes. By the delay in the flow of the solution into the nasal cavity, it is easy for physicians to judge the degree of narrowing of the ducts.

Diagnosis using contrast radiography shows the level of fusion of the lacrimal canals. The causative agents of the disease are detected by bacteriological culture.

An examination of the patient by a neurologist, neurosurgeon, dentist and otolaryngologist can be an addition to the examination.

The doctor diagnoses "obstruction of the lacrimal canal in a newborn" based on the anamnesis, a characteristic clinical picture and the results of additional studies.

Please note: the collar head test can be considered positive if, after 2-3 minutes after instillation of the dye, the baby's conjunctiva brightens.

Important: differential diagnosis is carried out with conjunctivitis. A number of clinical manifestations of these diseases are similar to each other.

Fluorescent dye test. The test is done to check how well the drainage system of the eye is working. A drop of a special solution with a dye is instilled into the patient's eyes. If a large amount of dye remains on the eye after a few minutes with normal blinking, then there is a problem in the outflow system.

Probing of the lacrimal canal. The doctor may use a special thin instrument to probe the canal to check if it is open. During the procedure, the channel expands, and if the problem was before the procedure, then it can simply be resolved.

Dacryocystography or dacryoscintigraphy. This study is designed to obtain an image of the outflow system of the eye. Before the examination, a contrast agent is instilled into the eye, after which an X-ray, computer or magnetic resonance imaging is taken. The dye highlights the tear ducts in the pictures.

In order to identify the disease, the patient must be examined by an ophthalmologist. As a rule, dacryocystitis is easily diagnosed due to its characteristic clinical symptoms. During the examination, the doctor conducts an external examination and palpation of the lacrimal sac area, conducts a lacrimal-nasal West test, an instillation fluorescein test, and an x-ray of the lacrimal ducts.

The most commonly performed lacrimal-nasal West test. It is one of the most common diagnostic techniques. During this procedure, a solution of collargol or protargol is instilled into the conjunctival sac. These stains are used to determine the patency of the lacrimal canal.

Methods of treatment

The eyes are the mirror of the soul. When there is a problem with the eye, it is not worth the risk. Treatment should be prescribed by a doctor after a preliminary diagnosis. The method of treatment is selected depending on the form and cause of the pathology that provoked it, age characteristics.

Treatment methods:

Washing the eye with antibacterial and disinfectant solutions.
The use of special drops and ointments.
Massage treatments and compresses to help clear the canal.

Washing the eyes with antiseptic solutions is carried out several times a day. The procedure is performed by an ophthalmologist in a hospital setting.

Ointments and drops that have an antibacterial effect:

Phloxal. Antibacterial preparation of a wide spectrum of influence. Fights the inflammatory process. The course of treatment is 10 days, two drops twice a day.
Dexamethasone. Drops with antibacterial effect. Effective in infectious processes. Bury 5 times a day. The required dosage and course of treatment are selected by the doctor individually for each patient.
Levomycetin is a hormonal drug. It is used for allergic reactions and inflammation.
Ciprofloxacin. It is prescribed for infections of the lacrimal canal. Buried every three hours.

If the treatment does not have a positive effect, bougienage is performed - cleaning the lacrimal canal from purulent contents;

You can quickly cope with the disease only with timely treatment. With negative symptoms, you need to visit an ophthalmologist.

Depending on the age of the patient, the cause and nature of the course of the disease, an individual treatment of inflammation of the lacrimal canal is prescribed. For adults, the ducts with symptoms of inflammation are washed with a disinfectant. If surgical treatment of inflammation is required, in this case, endoscopy is performed. This complex operation is completely painless. Sometimes the operation is performed in the usual way.

Methods of Pediatrics

Treatment and symptoms of inflammation of the lacrimal canal in children. In the case of a small child, in order to clean the lacrimal canal, the mother is recommended to massage daily in the area where the lacrimal ducts are located, as if squeezing out purulent discharge from them and freeing the ducts. Together with the massage, antibacterial drops are prescribed, the laying of tetracycline ointment. Several times a day, the child's eye should be washed with a decoction of chamomile, tea leaves or a weak solution of aloe juice.

Surgical treatment is carried out with the complete ineffectiveness of traditional therapy for a certain period. Before the operation itself, the child is prescribed antibacterial treatment in order to prevent complications during the operation, since the infection can also enter the brain through the blood. The operation is performed under full anesthesia.

If you suspect that your child has symptoms of an illness, in no case should you try to solve the problem yourself. Any purulent processes that eyewash at home can entail can be life-threatening for your baby. The specialist will massage the lacrimal canal for several days in order to break the membrane artificially.

If the obstruction caused symptoms of inflammation, then before receiving qualified medical assistance, you can wipe the inflamed area with a sterile cloth soaked in chamomile decoction. Such a compress must be applied every hour.

2. Rhinoscopy.

1. The severity of the disease.

5. Age of the patient.

Treatment of pathology depends on the causes and form of dacryocystitis. Its goal is to restore the patency of the lacrimal canals, to conduct therapy that allows you to restore the lost function of the ducts.

Anti-inflammatory therapy

At the initial stage, the patient is prescribed anti-inflammatory, antibacterial, vasoconstrictor drugs in the form of ointments or drops. To reduce the activity of bacteria, Floxal (active ingredient ofloxacin) is often used. The drug is used during the operation for two weeks. The dose of the medicine is prescribed by the doctor.

Photo 1. Sofradex eye and ear drops, 5 ml, from the manufacturer Sanofi Aventis.

Sofradex and Chloramphenicol drops are used to relieve inflammation and swelling of the ducts. In the acute form of the pathology, they are replaced by Cefukrosime.

The elimination of the infection is facilitated by the sanitation (cleaning) of the conjunctiva using solutions of Neomycetin, Levomycetin, sodium sulfacyl. The effect is enhanced by the introduction of corticosteroid drugs in combination with Prednisolone and other hormonal agents.

Massage, washes, compresses, UHF procedures, vitamins

To consolidate therapeutic therapy, the patient is prescribed vitamins, washing the nasolacrimal canal, UHF, and massage.

The latter, in fact, is not a massage. The purpose of the procedure is to stimulate the lacrimal duct and empty the lacrimal sac.

Massage is carried out with gloves and is accompanied by the introduction of medical agents into the lacrimal canals, which are prescribed by an ophthalmologist. The massage algorithm for dacryocystitis is as follows:

Squeeze the inner area of the eye with a finger, turn it (usually index) towards the bridge of the nose, and then compress the region of the lacrimal sac to cleanse it of purulent fluid.
After squeezing out the pus, the lacrimal canal instilled with furatsilin.
The purulent liquid and the remnants of the product are wiped with a cotton pad.
The area of the lacrimal canal is massaged again, while making jerky movements in the direction from the inner corner of the eye down.
Massage actions are repeated 5 times.
The lacrimal canal is instilled with an antibacterial agent.

Stimulation is carried out every day, 5-6 times, for two weeks.

Attention! Washing the lacrimal canal is more correctly classified as a procedure aimed at diagnosing the disease. With the help of it, the passivity of the lacrimal duct is usually established. True, sometimes, by systematic washing, a partial expansion of the lacrimal canal is achieved.

Folk remedies

The use of traditional medicine is effective for congenital dacryocystitis or in case of early diagnosis. Most often, eyebright, Kalanchoe pinnate are used for therapy. The juice of the latter disinfects the lacrimal ducts.

Before use, the leaf of the plant is torn off, washed, wrapped to dry in a cloth and cooled in the refrigerator from several hours to a day. Next, the leaf of the plant is crushed and the juice is squeezed out. It should not be used in high concentration. Therefore, the finished juice is diluted with saline in a ratio of 1: 1. And only after that, half a pipette is instilled into each nostril.

Photo 2. Eyebright extract, 40 capsules of 0.4 g, from the manufacturer "Ria Panda".

Eyebright is applied according to the annotation. This is a ready-made drug in the form of tablets and tinctures. To enhance the effect, the liquid is mixed with homemade decoctions of walnut, fennel, chamomile. The solid form of the drug is taken orally. The tablets can also be dissolved in water for daily eyewash as directed by a physician.

The patient is operated on if the disease is diagnosed too late or progresses.

Bougienage technique and effectiveness

A common method of intervention is bougienage with a probe. Bug, that is, with a rigid probe during the procedure, a blockage that has fallen into the tear ducts breaks through. The lacrimal canal, which is intended for the outflow of fluid, becomes slightly wider. Permeability is improved as a result.

Dacryocystoplasty and endoscopic dacryocystorhinostomy

Balloon dacryocystoplasty is performed using a conductor with a microscopic balloon. The entire structure is carefully inserted from the hole located in the corner of the eye. The expansion balloon is brought to the place of narrowing (blockage) of the channel.

Under pressure, it breaks and the lacrimal fluid contained in it presses on the walls of the lacrimal duct and pushes them apart. The structure is then removed. Surgery does not require general anesthesia.

A laser is used to perform endoscopic dacryocytorhinostomy. Using it, the doctor removes the mucous membrane of the lateral wall of the nose in the projection of the lacrimal sac, in order to then form a hole with a diameter of 5 mm in another part of the organ.

Reference! The operation is painless for the patient, does not require subsequent, long-term observation of a doctor, gives a good result, does not leave a cosmetic defect.

By the third week after birth, in many babies, the rudimentary film in the channels disappears on its own, due to which the problem is solved by itself.

Conservative treatment of blockage of the lacrimal canal

Treatment depends on the specific cause that caused the blockage or narrowing of the canals. Sometimes multiple treatments are needed to correct this problem.

If an infection is suspected, the doctor will likely prescribe antibiotics.

If the tumor has caused the obstruction, then treatment will focus on fighting the tumor. To do this, the tumor is usually removed surgically.

Conservative treatment

In a large percentage of infants, a congenital tear duct obstruction resolves on its own in the first months of a child's life. If this does not happen, then at first the doctor will recommend giving the child a special massage, and to fight the infection, he will prescribe drops containing antibiotics.

Minimally invasive treatment

Minimally invasive methods are used to treat congenital blocked tear ducts in young children when other methods have failed. The most common method is bougienage, in which a special tube is inserted into the lacrimal canal to restore its patency. The procedure does not require anesthesia and takes only a few minutes. After bougienage, the doctor will prescribe antibiotic eye drops to prevent infection.

Surgery

Folk remedies

After prior approval with a doctor, traditional medicine is successfully used at home.

Folk remedies:

Aloe. In case of inflammation, it is good to instill freshly prepared aloe juice, half diluted with saline.
Eyebright. Prepare in the same way. Use for instillation of eyes and applying compresses.
Chamomile has an antibacterial effect. You need to take 1 tbsp. l. collection, boil in a glass of boiling water and insist. Apply as an eye wash.
Thyme. Due to its anti-inflammatory properties, the infusion is used for dacryocystitis.
Kalanchoe is a natural antiseptic. Cut the leaves and keep in the refrigerator for two days. Next, extract the juice and dilute in a 1: 1 ratio with saline. This tool can be used to treat children. Adults can instill 2 drops of concentrated juice into the nose. The person begins to sneeze, during which the lacrimal canal is cleared of pus.
Leaves from a rose. Only those flowers that are grown on their own plot are suitable. It will take 100 gr. collection and a glass of boiling water. Boil for five hours. Use in the form of lotions.
Ivy-shaped burda. Boil a tablespoon of herbs in a glass of boiling water, boil for 15 minutes. Apply for washes and compresses.
Bell pepper. Drink a glass of sweet pepper fruit every day. adding a teaspoon of honey.

Indications for the procedure

Washing can be performed both for diagnostic purposes and for the treatment of certain ophthalmic diseases:

ulceration of the cornea, which requires sanitation of primary infectious foci;
congenital or manifested in newborns in the first weeks of life dacryocystitis (in the first case, the washing procedure can be avoided by performing canal massage, but sometimes such manipulations do not help);
mild nasolacrimal duct stenosis;
stenosis of the lacrimal ducts.

The washing procedure can be an effective way to treat inflammation (canaliculitis), but this action must be preceded by the cleansing of the channels from the inflammatory secret formed in them.

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Do warming up (using reflector lamps, cloth bags). It is advisable to perform the procedure several times a day.
Apply steamed sachets of chamomile or a cotton swab dipped in chamomile solution. It should be borne in mind that the infusion should be warm, but in no case hot.
Make compresses from calendula infusion.
Bury the nasal passage with Kalanchoe juice (the Kalanchoe juice must first be diluted with saline, since pure juice is very concentrated).
Use for lotions infusion of calendula flowers, mint leaves, dill, oregano, eucalyptus and sage (all herbs must be taken in equal proportions).
Apply parsley compresses to the inflamed area.

Inflammation of the tear duct: symptoms and possible complications

8. Dizziness.

9. Blue tissue.

13. Loss of appetite.

3. Edema of the eyelids.

5. Severe pain.

6. Headache.

7. Sleep disturbance.

Due to the fact that tears cannot flow where they are supposed to, the liquid stagnates, becoming fertile ground for fungi, bacteria and viruses. These microorganisms can cause permanent eye infections.

In infants, the main sign of an obstructed tear duct is suppuration (“sourness”) of one or both eyes. The doctor immediately prescribes drops with antibiotics, the condition improves, but after the treatment is stopped, the infection reappears.

Most often the disease is complicated by dacryoadenitis, dacryocystitis. Obstruction of the lacrimal ducts potentiates the formation of dacryolites, which entails the development of dacryolithiasis. Patients are at risk of developing inflammatory lesions of the anterior segment of the eyeball (conjunctivitis, keratitis, blepharitis).

Forecast and prevention

The prognosis for the treatment of dacryocystitis in case of timely access to a doctor is favorable. But with complex forms of pathology, complications are possible - decreased vision, a thorn and frequent relapses. For the purpose of prevention, it is recommended to treat diseases of the throat, nose and ears at an early stage and not injure the eyes.

The exact causes of obstruction can be different, so there is no single method of prevention. To reduce the risk of infection, you should follow the rules of personal hygiene, do not rub your eyes with your hands, avoid contact with people with conjunctivitis, never share cosmetics with strangers, and handle contact lenses properly.

Pathology is characterized by a favorable outcome. Specific preventive measures have not been developed. Non-specific prevention comes down to proper care of the conjunctiva of the eyes and nasal cavity in newborns. If you suspect an obstruction of the lacrimal ducts, an ophthalmologist's consultation is indicated. A child with this pathology in the anamnesis should be registered in the dispensary.

There are no specific methods of prevention. Pathology is most often congenital, so it either exists or it does not. It is recommended to treat sinusitis and conjunctivitis in a timely manner, monitor personal hygiene, and do not rub your eyes with dirty hands. In case of eye diseases, avoid exposure to wind, cold or direct sunlight.