Dacryocystitis
General characteristics of the disease
Dacryocystitis is a blockage of the nasolacrimal canal due to inflammation of the lacrimal sac. The cavity of the eye is washed by tears, preventing it from drying out and reproduction of pathogenic bacteria in it. Then the lacrimal fluid enters the lacrimal points located in the inner corner of the eye on the lower and upper eyelids. Dacryocystitis develops if one of these points becomes inflamed and clogged, as well as if the general patency of the lacrimal-nasal canal, lacrimal sac, and lacrimal tubules is impaired.
With dacryocystitis, the natural outflow of tears is disturbed. The fluid collects in the eye and is constantly poured out through the lower eyelid. Dacryocystitis of newborns does not always need treatment. Until the 3rd week of life, it is considered a natural physiological phenomenon, since the child's lacrimal ducts are closed with a gelatinous film. If this film breaks on its own, treatment is not required for a newborn with dacryocystitis.
With dacryocystitis in adults, consultation with an ophthalmologist is required. It is important for the differential diagnosis of dacryocystitis from conjunctivitis, in which both eyes become inflamed at once. Dacryocystitis in adults does not go away on its own without massage, medication, and sometimes surgical treatment.
Dacryocystitis reasons
The causes of dacryocystitis in newborns and adults are usually different.
Partial or complete blockage of the lacrimal canal, leading to dacryocystitis in adults, is most often caused by atherosclerotic phenomena or infections.
Dacryocystitis in newborns occurs as a result of the preservation of a gelatinous plug that protected the lower part of the lacrimal canal during the prenatal period. Normally, this film should break with the baby's first breath. Sometimes her rupture occurs within 2 weeks of a child's life.
About 5% of babies in the first months of life need treatment for dacryocystitis in newborns for the reason that an independent rupture of the gelatinous film has not occurred.
Dacryocystitis of newborns of infectious etiology is much less common.
Dacryocystitis symptoms
The symptoms of dacryocystitis include chronic lacrimation and swelling of the lacrimal sac located in the lacrimal fossa near the inner corner of the eye. When pressed on this area, dacryocystitis manifests itself as purulent or mucopurulent discharge. The conjunctiva of the eyelids also looks edematous.
The course of dacryocystitis can also be acute. With it, there is a sharp reddening of the lacrimal sac area and closure of the palpebral fissure. A fistula forms in the inner corner of the eye over several days. It can open up on its own with the release of the purulent contents of the lacrimal sac.
With a long chronic course of dacryocystitis in an adult or a child, severe stretching of the lacrimal sac is possible. In this case, the skin covering it becomes thinner and becomes bluish.
Dacryocystitis is dangerous to eye health, as it can lead to corneal infection, damage, and vision problems.
Diagnosis of dacryocystitis
The diagnosis of dacryocystitis is based on the patient's complaints and the clinical picture with characteristic symptoms of the disease. You can confirm the blockage of the lacrimal canal using the West test. For this, a cotton wick is inserted into the patient's nose, and collargol solution is instilled into the eye cavity. After a few minutes, with intact patency of the lacrimal canal, the wick should be colored. To clarify the place of obstruction of the lacrimal passages with dacryocystitis, you can use contrast radiography.
Dacryocystitis treatment
The standard of treatment for dacryocystitis in newborns is the systemic use of massage. With dacryocystitis, it is carried out at least 2 weeks up to 10 times a day. With regular and correct massage, dacryocystitis in most cases is cured without the use of surgical treatment.
The purpose of the massage for dacryocystitis is to break the gelatinous film. All manipulations are carried out with clean hands at home by the parents of the child. Massage for dacryocystitis begins with squeezing out the contents of the lacrimal sac. Then, a solution of furacilin is instilled into the eye cavity, and purulent discharge is completely removed. And only then you can proceed directly to the therapeutic massage. With dacryocystitis, massaging jerky movements with the fingers should be carried out in the area of the lacrimal sac. After the massage, disinfectant drops should be dripped into the eye.
If massage is ineffective in the treatment of dacryocystitis in a newborn, the child is sent to probing the nasolacrimal canal. Surgical treatment of dacryocystitis in newborns is recommended at the age of 2-3 months. It is performed under general anesthesia and is successful in most cases.
In children over 3 years of age, as well as with dacryocystitis in adults, dacryocystorhinostomy is recommended. During it, an artificial nasal lacrimal canal is modeled, the communication between the eye cavity and the nose is connected.
With dacryocystitis of newborns, it is possible to use low-traumatic laser dacryocystorhinostomy. Surgical treatment of dacryocystitis in adults involves the use of external or endonasal dacryocystorhinostomy.
Lacrimal sac resection in adults with dacryocystitis is used only in exceptional cases. At the initial stage of the disease, disinfecting and antibacterial lavages, nasal probing, as well as UHF therapy and warming compresses are used for acute dacryocystitis in adults.
YouTube video related to the article:
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
