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The first sign of an inflammatory process in the lacrimal ducts is souring of the eyes. It is difficult to immediately recognize the disease, since a similar symptom is present in a disease such as conjunctivitis. In addition to purulent discharge, the inflammatory process of the lacrimal canaliculus is accompanied by swelling of the inner eye corner.
Causes of inflammation of the lacrimal canaliculus
The main reason for the development of the inflammatory process is the blockage of the lacrimal canal due to the fact that at birth the child did not break the film that protects the eyes of the newborn inside the womb from amniotic fluid. The film also protects the nose and respiratory tract from amniotic fluid. Usually it breaks on its own immediately after the birth of the baby with his first cry. But it happens that the film remains intact, and this further prevents the normal process of tearing.
As a result, tears accumulate in the lacrimal sac, its deformation occurs and, as a result, the development of the inflammatory process is provoked.
Probing the lacrimal canaliculus in a newborn will help to radically solve this problem. Typically, the procedure is performed on children at the age of two or three months, but the procedure is also allowed at an earlier age, if there are direct indications for this.
Risk categories include children with Down syndrome, craniosynostosis, Goldenhar sequence, cleft syndrome, hemifacial microsomia, or any midline facial anomaly.
It is worth noting other causes of dacryocystitis (inflammatory process of the lacrimal ducts).
Among them are involutional stenosis (the most common cause of NLD obstruction in the elderly), neoplasms in the lacrimal sac, Sinus disease (congenital or acquired after incorrect surgical intervention – damage to the sinus), trauma (naso-orbital fractures), inflammatory diseases, neoplasms.
Diagnosis of dacryocystitis
During the examination, the doctor may express his opinion regarding the obstruction of the lacrimal canal. In order to refute or confirm the assumption, a West test is performed. For the diagnostic procedure, a special dye (a three percent solution of collargol) is instilled into the eyes, and a cotton swab is inserted into the nose.
If paint appears on the swab within three to five minutes, then there is no inflammatory process in the lacrimal canal. If the cotton wick remains clean, the doctor diagnoses the presence of a disease such as dacryocystitis. When diagnosing a disease, the doctor without fail prescribes:
- drug treatment;
- massage;
- sounding.
Probing algorithm
The procedure is performed in a manipulation room in a clinic by a highly qualified ophthalmologist. During the preparation period, it is necessary to visit a professional otolaryngologist to exclude the presence of a deviated nasal septum. Also, before the procedure, the doctor without fail prescribes a UAC and a blood test for clotting.
The duration of the procedure is a total of 5 to 10 minutes. All manipulations are performed under local anesthesia. Drops with an anesthetic effect are instilled into the eyes twice. After that, by using a special conical-shaped instrument (Sichel probe), the ducts are expanded.
Next, the doctor takes a longer tool (Bowman probe) and inserts it to the required depth, breaking the interfering film. After breaking the film, the doctor thoroughly rinses the lacrimal canal and disinfects it. For this manipulation, drugs that are safe for the mucous eyes and saline are used.
After all the manipulations have been carried out, the doctor makes sure of its success. For this, the West test is repeated. If drops of paint appear on the swab, this is an indicator that the film has been successfully broken through and the conjunctiva has been completely cleaned.
If massage and drug treatment did not help solve the problem, and the probing procedure is simply necessary, you will have to endure all the discomforts. This is especially true for small children. Although the procedure is carried out exclusively after anesthesia, the child will still cry – and this is a natural reaction of the newborn, as he is touched, a lamp shines in his face, and there are strangers around. After the procedure, the discomfort disappears quickly.
Actions after probing
In order to consolidate the effectiveness of the procedure, the patient is required to appoint:
- a weekly massage of the lacrimal ducts, which is carried out gently with fingertips (hands must be in sterile gloves or carefully disinfected so as not to cause infection);
- drug treatment with antibacterial action.
Drug treatment is prescribed according to the age of the patient. If the patient has a deviated nasal septum or an abnormal change in the lacrimal canal, the procedure is completely pointless.
Complications after the procedure
Any surgical intervention has its own complications, and probing of the lacrimal ducts is no exception. After all, each patient has an individual organism and each reacts differently to anesthesia and to the intervention of a surgeon. Among the frequent complications, it is worth noting scarring of the canal puncture site. The scar can cause re-occlusion of the canal. In order to prevent scarring, it is necessary to follow the doctor’s recommendations as accurately as possible after probing.
It is important to carefully monitor the condition of your eyes and the condition of the eyes in newborns (the disease is most often visualized in children from 3 to 6 months old), and if any discomfort, souring of the eyes, inflammation of the corners of the eye appear, it is imperative to consult a doctor . It is important to remember – no self-medication, as serious side effects can be provoked.