home Audience 2 Probing the lacrimal canal in newborns - how is the procedure performed? How is probing of the lacrimal canal performed in newborns? How much does probing of the lacrimal canal in newborns cost?

Probing the lacrimal canal in newborns - how is the procedure performed? How is probing of the lacrimal canal performed in newborns? How much does probing of the lacrimal canal in newborns cost?

Blocked tear ducts subsequently interfere with the healthy flow of tear fluid. This subsequently leads to an inflammatory process. Most often, this problem occurs in adults. The causes of this pathology are congenital characteristics, injuries and diseases. Inflammation may require probing of the tear duct in adults.

Probing the tear duct in adults

As the disease progresses, the symptoms become more pronounced. In this article you will become familiar with effective treatment methods, such as the use of medications, bougienage of the lacrimal duct in adults, and surgery.

Reasons for appearance

Blockage of the tear ducts (dacryocystitis) is an inflammatory process. It affects, which is located between the nasal septum and the inner corner of the eye. As a result of the blockage, pathogenic microorganisms can accumulate. Their activation leads to the onset of inflammation and disruption of fluid outflow.

Diagram of the lacrimal duct

Most often, obstruction of the tear duct occurs due to the following reasons::

Congenital pathology of patency. The defect appears at birth and may disappear in the first months of life. However, sometimes it may remain. In this case, it is necessary to pierce the lacrimal canal.
Non-standard development of the skull and face.
Infectious diseases and inflammatory processes.
Surgical operations performed on the eyes.
Injuries and damage to the face. Misaligned bones can interfere with the normal flow of fluid.
Tumors on the face. Formations that arise in the nasal bones and lacrimal sac can block the canal. This happens if the tumor increases in size greatly.
Medicines for external use. Some eye drops cause obstruction of the tear ducts.
Medicines for internal use. Obstruction occurs as a side effect of taking certain medications.
Irradiation. If a person has suffered from cancer during treatment, the risk of blockage increases significantly.

Symptoms of the disease

The blockage may occur in one or both eyes. Inflammation of the tear duct may be accompanied by the following symptoms:

increased tearfulness;
frequent occurrence of conjunctivitis;
inflammation and swelling in the corner of the eye;
discharge of mucus or pus from the eyes;
the appearance of traces of blood in the tear fluid;
decreased clarity of vision.

It is important to know! At the initial stage of the disease, this disease manifests itself quite weakly. The patient may feel discomfort in the lacrimal sac. After a certain time, severe pain and redness of the skin may occur.

Diagnostics

To confirm this diagnosis, the ophthalmologist may prescribe certain tests. These include:

Dye test. Doctors instill a special solution with dye into the patient's eyes. If after a few seconds a large amount of dye is observed in the eyes, this will indicate that the channel is clogged.
Channel sounding. Using a special instrument, doctors penetrate the tear duct. In the process of puncturing the tear duct, it expands, and the problem can be solved.
Dacryocystography. X-ray of the lacrimal canals with the introduction of a dye into them. Using this method, specialists will see the outflow system of the eye.

Bougienage probe

If the diagnosis is confirmed, then experts prescribe bougienage of the lacrimal canal in adults.

Treatment

Treatment for the disease will depend on the cause that caused it. To combat a complex illness, they can use:

Antibiotic therapy. If the disease is caused by an infection, then antibiotics are prescribed: ciprofloxacin, chloramphenicol, and also Erythromycin.
Bougienage. Probing the lacrimal canal in adults is a more gentle method. To carry out such a procedure, a special probe can be used. Its introduction is carried out through the lacrimal opening and mechanical cleaning of the lacrimal canal begins. The therapy method can be considered completely painless, but you may encounter unpleasant sensations. Sometimes the patient is given intravenous anesthesia before undergoing this procedure. The procedure takes a few seconds. In advanced cases, it may be necessary to repeat bougienage, which is performed at intervals of several days.
Eye drops. You can also get rid of blocked tear ducts using the following eye drops:

. These drops have an antibacterial effect. The active substance present in the composition is the antibiotic ofloxacin. 1 drop should be instilled into the lower conjunctival sac up to 4 times a day. In some cases, Floxal ointment can also be used. It is placed under the lower eyelid up to 3 times a day. Only allergic reactions can be a contraindication.
. Should be used 1-2 drops up to 4 times a day. Contraindications include severe kidney disease, auditory neuritis, as well as hypersensitivity to the ingredients of the drug.
. These are antiviral eye drops. Doctors will instill 1-2 drops up to eight times a day during acute inflammatory reactions. Then the number of instillations is reduced to 3 times. Contraindications to the drug include hypersensitivity to its components.

Floxal eye drops are an effective antibacterial agent.

If drug treatment does not work, then more serious treatment methods are prescribed.

Tear duct surgery in adults

Surgery is usually prescribed in difficult cases. The operation has the following types:

Endoscopic dacryocystorhinostomy. During the surgical procedure, a flexible endoscope with a camera is inserted into the tear duct. With its help, a small incision is made on the affected area. The operation will be available to patients who do not have allergic reactions. The duration of the rehabilitation period is up to 8 days. The advantages of such an operation are that after it is performed there are no visible scars left on the skin and the tear ducts are not damaged.
Balloon dacryocytoplasty. This is a safe surgical intervention that is performed even on children under one year old. Specialists insert a thin conductor into the tear duct. It contains a bottle with a special liquid. At the site of blockage, a pressure balloon expands the problematic area of the tear duct and helps clear it. Local anesthesia may be used during the procedure. After surgery, you may be prescribed to use antibacterial drops.

Carrying out balloon dacryocytoplasty

Blockage of the optic ducts is a common pathology in newborns. Its appearance may be associated with prolonged labor or intrauterine infection. 30% of children encounter the problem of obstruction of the lacrimal duct within 1 month of life.

In 70% of cases, the problem can be resolved only with the help of probing.

There are not many reasons for the development of obstruction and inflammation of the nasolacrimal duct.

In most cases, pathology is detected immediately after birth and occurs due to:

abnormal structure of the nasal septum;
underdevelopment of the lacrimal canal;
preserving the film that should have broken through during the first breath and cry of the child once after birth;
genetic pathologies of the structure of the bones of the skull or face;
eye infections;
entry of a foreign body into the lumen of the canal;
tumor formations.

The most common cause of blocked eye ducts is the baby's lack of prolonged and strong crying immediately after birth.

Symptoms of inflammation of the lacrimal duct in newborns

Inflammation of the tear duct develops gradually, the symptoms may not be noticeable, but you should pay attention to:

the appearance of tear drops when the child does not cry;
moisture in the lower eyelashes after sleep;
frequent blinking;
constant scratching of the eyes.

After the initial stage, the pathology develops into dacryocystitis, which has more pronounced symptoms:

The pathology can affect not only both eyes, but also be one-sided.

Indications for probing the lacrimal canal

Surgical breakthrough of the protective film is prescribed only after conservative treatment. If there are no positive results or the condition worsens, the ophthalmologist gives permission to perform the procedure.

Indications for surgical intervention are also:

profuse lacrimation;
increase in the inflammatory process;
change in color of purulent contents from yellow to green;
ineffective treatment with massage;
disturbances in the formation of the lacrimal canal;

Contraindications

Probing the lacrimal canal in newborns has a number of contraindications, including:

abnormal structure of the optic ducts;
acute sinusitis;
chronic sinusitis;
allergic manifestations in the form of cough or runny nose;
curvature of the nasal septum;
hemophilia;
altered blood composition;
diabetes;
infectious diseases;
leukemia;
conjunctivitis;
facial injuries;
increased sensitivity to painkillers;
pneumonia;
asthma;
tumors;
heart failure.

If there are contraindications or congenital anomalies, the ophthalmologist may reschedule the operation at a later date or prescribe maintenance therapy.

Preparing a child for sounding

Probing is one of the types of surgical interventions, so it requires special preparation.

Before it is carried out, it is necessary to undergo a number of examinations:

Doctor/test	Study
Otolaryngologist	Examination of the nasal septum, throat and ears. It is necessary to exclude pathologies of the structure of the nasal and ocular areas.
Pediatrician	Exclusion of infectious or bacterial infections, inflammations. Checking your general health.
General blood test	Identification of internal sluggish pathologies or inflammations.
Biomicroscopy of the eye	Examination of the fundus, apple and cornea. This method allows you to detect foreign bodies, retinal tears and pathologies of the optic nerve.
Coagulogram	A blood clotting test to rule out the possibility of bleeding or blood clots.
Bacteriological analysis of purulent contents	This examination reveals the presence of pathogenic microflora of the eye and mucous membranes. It allows you to select the most effective antibiotic.
Test Vesta	A tear duct patency test will reveal the extent of the blockage. If the canals have sufficient patency, it is advisable for the child to undergo a procedure to expand them.

When receiving all the results before probing, it is recommended:

follow a strict diet 3 days before surgery;
do not feed the baby 4 hours before;
stop taking all medications.

To avoid injury or serious complications, the baby's arms and legs must be firmly secured with diapers. It is worth noting that many clinics swaddle children themselves before surgery, so this point will be clarified during consultation.

Carrying out the operation

Probing of the lacrimal canal in newborns is carried out quickly. All manipulations take no more than 10 minutes. The operation can be performed under local anesthesia. Most often, the painkiller Alcaine is instilled into the eye. The use of general anesthesia is advisable only for the treatment of bilateral dacryocystitis or when the child reaches the age of 4 months.

Probing procedure:

The eyes are washed with a special solution and the surrounding skin is treated with an antiseptic.
A Sichel tube, which has a cone shape, is inserted into the lumen of the duct near the upper eyelid. It is necessary to expand the tear ducts. The tube is first inserted horizontally and then raised vertically.
Then a Bowman probe, which is a thin hollow wire, is also inserted. It is used to tear the film.
After restoring the patency of the ducts, the tear-purulent contents are washed out with saline and the eyes are treated with a disinfectant.

After 20-40 minutes. the child is sent for outpatient treatment and a date for re-examination is set.

Many clinics are practicing a new method of treating obstruction of the optic ducts. The operation differs only in the introduction of special soft rubber tubes instead of probes.. They contain a small ball that is inflated with air or saline.

After the film breaks, the ball is removed, and the tubes remain in the ducts for about 6 months, preventing the formation of adhesions, after which they are removed.

Risks and possible complications in newborns

Removing blocked tear ducts is considered a safe procedure.

There are practically no risks of aggravating the problem or causing harm to health, since:

all instruments are sterilized;
modern painkillers are used;
After the operation, the open ducts and eyes are disinfected.

The course of the operation directly depends on the qualifications of the microsurgeon, since if the procedure technique is violated, pus can get into the second eye or ear. Probing is recommended before the child reaches 6 months of age., since the film in the ducts hardens, complicating the operation.

There is also a risk of re-development of dacryocystitis after the procedure if the rules of care for the operated visual organs are not followed or if they become infected with infectious and colds after probing.

During the first few days after surgery, it is considered normal to experience:

If these symptoms intensify or do not go away within a few days, you should consult an ophthalmologist or pediatrician.

Serious complications that require immediate medical attention include:

conjunctivitis;
lack of tear fluid;
severe eye irritation or redness;
temperature above 38°C;
bleeding from the eyes;
formation of scars and adhesions;
vomiting;
severe flow of tears 14 days after surgery;
mechanical damage to the channel.

If left untreated, blockages of the eye ducts may develop:

How is recovery going?

Probing the lacrimal duct has a long recovery period. It is 2 weeks. In newborns and children up to 3 months, this period extends to 1 month. Rehabilitation is carried out at home in the absence of serious complications.

Recovery is faster if you follow all the ophthalmologist’s recommendations. It must be remembered that during rehabilitation you should not overcool and have contact with sick people, since any disease of the ENT organs can provoke recurrent dacryocystitis.

Also, during recovery, it is necessary to do a special massage, which prevents the growth of scar tissue or adhesions.

What is prohibited during the rehabilitation period

There are practically no strict restrictions during rehabilitation. Immediately after the procedure, you can walk, but this must be done away from dusty roads. and children's playgrounds with sandboxes. For the first 2 days it is forbidden to bathe the child in the bath. You are only allowed to rinse it carefully under running water, without washing your hair and face.

Self-use of antibiotics can cause inflammation of the conjunctiva of the eyes and bacterial infection. During rehabilitation, it is necessary to refrain from introducing new foods into the child’s diet, and also to temporarily limit the consumption of salty and fatty foods.

It is also prohibited to overheat children and take them to a sauna or bathhouse, as high temperature can cause inflammation in the operated canals.

When is a repeat probing procedure necessary?

There are cases when one probing does not help eliminate the obstruction; a repeat procedure is performed if:

lacrimation has not recovered;
adhesions occur in the canals;
there is a relapse of dacryocystitis after an illness;
scar tissue forms.

The procedure is carried out no earlier than 2 months after the first sounding and is no different from it. If there is a physiological decrease in the lumen of the ducts, the microsurgeon may recommend installing special tubes for six months that prevent the narrowing of the ducts and the formation of adhesions.

Post-operative care

Probing helps eliminate duct obstruction in almost 98% of cases. After the procedure, you must adhere to certain rules for caring for the child. Mandatory manipulations during the rehabilitation period include massage and eye treatment.

Hygienic eye treatment

For 5-7 days, the child needs to drip special solutions and apply ointments. The type of medication, dosage and duration of treatment are prescribed by an ophthalmologist.

For treatment and disinfection, the following are often prescribed:

Name	Application	Peculiarities
Vigamox drops 0.05%	Any age	Long-term use of the drug provokes the growth of pathogenic insensitive microorganisms. If complications occur, correction of the treatment regimen is necessary.
Furacilin tablets	Any age	The product is well tolerated by children. It is necessary to rinse your eyes only with a freshly prepared solution.
Vitabax drops 0.05%	Any age	It is not recommended to use the product simultaneously with other eye products. Between uses you need to take a break of 20 minutes.
Drops Levomycetin 0.25%	From 12 months	The drug contains chloromycetin, which can accumulate in the liver and cause toxic damage. The product is not recommended for children under 1 year of age and people with liver pathologies.
Floxal ointment	Any age	If combined use with other drugs is necessary, the ointment is added last.
Ofloxacin drops 0.3%	From 12 months	The drug is well tolerated by the body of children, but in case of overdose, irritation of the eye membranes is possible. In this case, it is necessary to rinse them with clean water.
Tobrex drops 0.3%	Any age	It is not recommended to use the drug for more than 10 days, as the immunity of pathogenic organisms to the antibiotic increases.

Massage: technique, frequency

Probing of the lacrimal canal in newborns gives a positive result only when combined with massage and drug therapy.

Before the massage you must:

trim fingernails;
wash your hands thoroughly;
wear sterile gloves;
rinse each eye with furatsilin solution.

Caution must be exercised as infants have a very soft nasal septum.

The massage technique consists of several actions:

Feel the edge of the orbital bone at the inner corner of the eye, closer to the bridge of the nose.
Lightly press the corner of your eye with your finger.
Then move up to the eyebrow and down to the nose. The movement should follow the shape of the comma sign.
Pressure should not be applied to the cartilage tissue of the nose, but only to the eye window.

When purulent contents appear in the corner, it is carefully collected with cotton pads or gauze napkins. It is also necessary to repeat 4-7 movements for each eye. During the day, massage is carried out up to 4 times. After all the manipulations, the necessary medications are instilled into the eyes.

Is it possible to avoid probing? Alternative Treatments

You can eliminate obstruction of the tear ducts with massage. But this method does not always give a positive effect: It is possible to tear the film only in 50% of cases. The technique of therapeutic massage does not differ from postoperative massage, but the pressure should be applied in a jerky manner with great effort.

Also, to treat obstruction, massage should be performed up to 10-12 times a day, 6-10 movements, after which antibacterial agents should be used.

The video shows mistakes when performing massage of the lacrimal canal, and also explains the method of correct execution:

You can also use traditional medicine:

Mint, calendula and sage compress: mix 2 tbsp. herbs and pour 500 ml of hot water, leave for 3 hours. Apply gauze soaked in the broth every 2 hours for 10 minutes.
Nasal drops from Kalanchoe juice: Place several leaves in the refrigerator for 2 days, then chop them and squeeze out the juice. Dilute it in a 1:1 ratio with boiled water and drip the resulting solution onto your nose. This product can cause sneezing, which contributes to the physiological rupture of the film. The product can also be used in the form of lotions.
Boudra or chamomile decoction: 1 tbsp. Pour one of the herbs into a glass of clean water and boil for 5 minutes. The decoction should be used as a compress or to wash the eyes.

Probing of the ophthalmic ducts in newborns is carried out if the condition does not improve within 3 weeks.

In addition to the classical technology, there is another option for restoring the patency of the canals:

Intubation without the use of a Sichel probe.
Probing the lacrimal duct in newborns is the most effective method, but it is often replaced by the intubation procedure. It differs from it in the use of thin conductors to which silicone tubes are attached.

They are pushed through the superior and inferior ducts into the nasal cavity and removed. The tubes remain in the cavity of the canals and ensure the movement of tear fluid. The device can only be removed after six months, as new tissue forms around it, creating wider canal walls.

This method is used when:

partial obstruction of the canals;
unsuccessful probing;
formation of a purulent sac in the area of the ducts.

Possible complications include:

too large hole in the corners of the eyes;
changing the position of the tubes;
eyeball injury;
conjunctivitis;
discomfort in the nasal cavity.
Elimination of obstruction using a balloon device.

This method is rarely used due to the cost of equipment and the long duration of manipulations, but it has several advantages over classical probing.

Advantages:

no need to insert multiple probes;
in addition to film rupture, channels expand;
there is no risk of injury to the ducts and the formation of adhesions.

The manipulation is performed under general anesthesia. Thin conductors with a microscopic ball are inserted into the ducts. It is pushed closer to the film and filled with air or liquid. The ball expands and breaks the film. After this, it is pulled out using a guide.

This method is used in case of increased sensitivity to local anesthetic drugs or after unsuccessful probing.

Complications include:

relapse of dacryocystitis;
formation of an imaginary duct;
allergic reactions to anesthesia.

Treatment of obstruction of the lacrimal duct must be carried out immediately after diagnosing the pathology. Lack of proper and timely therapy can cause an abscess, which leads to death. It is also worth noting that probing in newborns can be performed under general anesthesia, which significantly reduces the possibility of adverse consequences.

Article format: E. Chaikina

Useful video about probing the lacrimal duct in newborns

You can learn about the causes of blockage of the tear duct and the results of successful probing from this video:

Many babies begin to experience health problems immediately after birth. This is especially true for eye pathologies. Inflammation of the tear duct leads to the development dacryocystitis. This disease occurs in 5% of all cases of eye diseases.

It is characterized by blockage of the canal lumen with a purulent plug. Also, this disease can occur with the first breath of a newborn, if the tear duct is not completely freed from the remnants of the film, which prevents amniotic fluid from entering the eyeball.

To fix this problem, you have to resort to probing the lacrimal canal. The procedure is unpleasant, but necessary, since the disease sometimes begins acutely and causes great discomfort to the baby.

Causes of tear duct obstruction

The lumen of the lacrimal canal may be blocked due to:

Congenital pathology, as a result of which an anatomical narrowing of the lacrimal duct is observed.
Abnormal structure of the nasal septum.
Incomplete removal of the protective film after childbirth.

The disease is characterized by a gradual increase in symptoms of inflammation and can develop over two months.

Many parents take the initial symptoms as the development of conjunctivitis and therefore are in no hurry to consult an ophthalmologist.

At the same time, the clinical picture of this process is supplemented by new symptoms that increase the severity of the inflammatory process:

The newborn's temperature begins to rise, sometimes to critical levels.
Accumulated pus causes difficulty in blinking the eyes; it accumulates at night, causing eyelashes to stick together.
Dacryocystitis occurs as a consequence and is accompanied by the appearance of a tumor in the lower eyelid.

Very often, the above symptoms are accompanied by a viral infection.

Symptoms of inflammation of the lacrimal duct in newborns

The development of dacryocystitis (inflammation of the lacrimal sac) most often develops gradually. The clinical picture may be supplemented by symptoms for two months.

Typically the disease develops as follows:

If parents do not pay attention to such manifestations and do not contact an ophthalmologist, the pathological process is aggravated by the appearance of an abscess or purulent melting of subcutaneous fat (phlegmon). Such complications tend to self-open and pose a real threat to the visual organ of a small patient.

Diagnostics

In addition to a visual examination, the ophthalmologist performs two tests that allow you to determine the condition of the lacrimal canal:

In addition to these samples, material is collected from the lacrimal sac. This is done to determine the type of pathogen and find out its tolerance to antibacterial drugs.

Indications for probing the lacrimal canal

This procedure is often carried out; it cannot be avoided if the newborn has:

Increased secretion of tear fluid.
The presence of dacryocystitis in acute or chronic form.
In cases where conservative treatment methods have not led to positive dynamics in restoring the patency of the lacrimal canal.
Suspicion of abnormal development of the lacrimal duct.

Preparing a child for sounding

Preparation stages:

Risk

Possible risks:

Probing the lacrimal canal can be considered a safe type of procedure. The instrument used is sterile, which minimizes the chance of developing an infectious process. The manipulation is performed using local anesthetics, which eliminate pain.
It is very important that when probing the lacrimal canal, the purulent contents do not flow into the second eye or penetrate into the auricle.
The probing procedure ends with washing the visual organs disinfectant solution.

Forecast

Prognosis after the procedure:

Carrying out the operation

This type of procedure takes no more than 20 minutes. To carry it out, the need to place the child in a hospital setting is eliminated. After this manipulation, the child is sent home, where subsequent outpatient treatment is carried out.

At the beginning of the operation, a local anesthetic is instilled into the eye. The skin around the eye is treated with a disinfectant solution.

Three stages of the tear duct probing procedure:

The procedure is considered completed correctly if the disinfectant solution pours out through the nasal passage.

Since medicine does not stand still, recently a small ball has been used instead of a probe. It is introduced into the lacrimal canal and filled with air, thereby helping to remove the plug or disrupt the integrity of the film, which did not break after the baby was born.

Repeated probing procedure

Sometimes there are situations when it becomes necessary to repeat this procedure.

The main reason for repeated probing may be:

Lack of the desired effect.
Formation of adhesions and scars after the first procedure.

Probing manipulation can be performed 2 months after the first procedure.

The second sounding is no different from the first. The only thing is that during the operation, a special silicone tube can be inserted into the lumen of the lacrimal canal; it prevents the development of the adhesive process. After six months it is removed.

This type of manipulation gives a positive effect in 90% of all cases.

The most important thing in the following months is to prevent the child from contracting colds.

They can cause re-development of lacrimal duct obstruction.

Therefore, the ophthalmologist prescribes:

Instillation of eye drops with antibacterial drugs. The dosage and choice of medication is carried out by the doctor.
To achieve positive dynamics, it is recommended to massage the lacrimal canal.

Sometimes there are cases when probing does not bring relief to a small patient. Most often this occurs due to incorrect operation (probing did not reach the location of the plug, or did not completely destroy it). In this case, the procedure is repeated again, or the diagnosis is clarified for further treatment.

Massage

Massaging the tear duct does not cause any particular difficulties.

If necessary, the first procedure is carried out by a doctor, he will teach the technique of performing basic massage movements:

Before performing this procedure, it is performed with a solution of furatsilin, or potassium permanganate (potassium permanganate). However, you should not use a highly concentrated solution. Potassium permanganate should have a pale pink color, the furatsilin solution should be pale yellow.
The massage begins with palpating the corner of the eyeball, located closer to the bridge of the nose. The location of the lacrimal sac is determined.
Under the index finger, it will be felt in the form of a tubercle. Massage movements involve light pressure, which is performed first towards the eyebrows and bridge of the nose, and then from the lacrimal sac to the tip of the nose.
If massage movements caused an outflow of pus, it must be removed with a sterile gauze pad.
The movement is repeated 10-15 times.
Pressing on the lacrimal sac must occur in the form of a push.

Proper massage procedure can prevent recurrence of dacryocystitis in the future.

Complications

After the procedure:

The recovery process after this procedure may take 2 months. During this period, the most important thing is to prevent the development of respiratory diseases.
Immediately after performing probing, Children may remain restless throughout the day.
Sometimes, bloody discharge may appear from the nasal passages. If they become abundant, you should consult a doctor.

There is also a possibility of developing the following negative consequences:

If the operation is performed after one year of age, the likelihood of complications increases markedly. After 6 years, probing of the lacrimal opening may not bring a positive effect, and this is the basis for a complex surgical operation using general anesthesia.

Conclusion

Parents of a newborn child should remember that at this age any disease requires increased attention, for which it is necessary to consult a doctor. Only an accurate diagnosis will eliminate the pathological process.

You should not self-medicate, as many eye diseases have a similar clinical picture. And parents who do not know the rules of differential diagnosis and who do not know medicine can do harm by self-treatment.

It should also be taken into account that early age does not cause side complications, and is much easier to tolerate for children.

Inflammation of the lacrimal duct can cause a threat to the child’s life if the parents do not take the development of this pathology seriously. Abscess and phlegmon, corneal ulcer are a serious threat to the baby’s visual organs.

Normally, after birth, a child undergoes a number of changes in the body, due to which newborn adapts to life outside mother's tummy. But sometimes some problems arise that require medical intervention. One of these problems is dacryocystitis - by this term doctors mean obstruction of the lacrimal duct. While the baby is in the womb, its tear duct is closed by a gelatin plug, which normally bursts during childbirth as soon as the baby screams.

Sometimes, for various reasons, this does not happen, and then we are dealing with a disease such as dacryocystitis, which occurs in 5% of newborns.

Unfortunately, the causes of this condition in no way depend on either the parents or the medical staff. That's why prevent they won't work.

The disease can develop due to the following reasons:

maintaining the integrity of the plug in the tear duct after the birth of the baby;
anatomical features of the structure of the lacrimal canal, namely its narrowing;
abnormal structure of the nasal cavity.

All this leads to the fact that the excretory processes are disrupted, all the liquid collects in the lacrimal sac, the canals become blocked with mucous secretions and dead epithelium, resulting in inflammation.

Symptoms of the disease

Usually, symptoms of dacryocystitis are obvious, and it is hardly possible to miss them. But we still recommend that you familiarize yourself with the dangerous signals that you should pay attention to.

Severe tearing. If a child does not cry, but his tears still flow, this is a clear sign of illness. A feature of the symptom is its objectivity, starting from the second month of life, when the child produces a sufficient amount of tears.
Perceptible swelling in the corner of the eye, which may vary in size.
Severe redness affected eye.
Discharge of pus.
One-sided nature, that is, dacryocystitis usually affects one eye.
If left untreated, hyperthermia (increased body temperature) appears and phlegmon may occur - purulent inflammation.

If a child experiences similar symptoms, do not wait until they disappear on their own; contact an ophthalmologist immediately to avoid complications.

After a small patient contacts an ophthalmologist with suspected obstruction of the lacrimal duct, the doctor must first confirm or refute this diagnosis.

Several techniques are used for this.

Methods for diagnosing dacryocystitis:

Tubular test. To understand whether a child has dacryocystitis, you need to make sure that the lacrimal ducts are obstructed. To do this, a colored solution called collargol is instilled into the affected eye. If the color disappears within 5 minutes, the diagnosis is not confirmed; if the absorption of the substance is slowed down to 10 minutes or more, the patency is absent or significantly impaired.
Nasal test. The procedure is similar to the previous one, but it is estimated how quickly collargol is absorbed into a cotton swab placed in the nasal passage after instillation of the eye.
Analysis of secretions from the lacrimal sac.

If, after the studies, the diagnosis of dacryocystitis is confirmed, an ophthalmologist will prescribe treatment. Depending on the patient’s condition, it can be either conservative or surgical.

Conservative treatment

As with most other diseases, before using surgery, the doctor tries to help the patient with conservative methods.

This tactic is especially relevant when it comes to a newborn baby.

To help a child without surgery, use:

Massage. Parents can massage their babies themselves, without visiting the hospital. This is especially important given the fact that massage sessions will have to be performed up to 6 times a day. Before you begin, you need to cleanse your eye of all dirt and secretions. The session itself consists of circular movements with the little finger in the corner of the eye. After finishing, wipe the affected area again with a cotton swab soaked in furatsilin to remove pus.
Drug treatment antibacterial drugs. Such products as Tobrex, Levomycetin, Vitabact, Vigamox and others are used.

Only if there is no improvement after conservative treatment, the doctor prescribes probing or bougienage of the lacrimal duct for the child.

Preparing for bougienage

Although bougienage is considered a procedure rather than an operation, it requires high precision from the doctor, and from parents a serious attitude towards preparing the child. Firstly, it is necessary to take into account the fact that probing is carried out under local anesthesia. And although this type of anesthesia is more harmless for the child’s body than general anesthesia, it is still worth strictly following the doctor’s instructions:

Examine the child by an otolaryngologist to rule out the presence of a deviated nasal septum.
Before carrying out the intervention, undergo a complete examination of the baby by a pediatrician to make sure that he is healthy and to exclude viral and bacterial infections. A general blood test is mandatory.
Do not feed your baby several hours before the procedure to avoid digestive problems. Check with your doctor for the time period.
Swaddle the newborn tightly in a previously prepared diaper so that it does not interfere with the operation.

The probing procedure is quite simple, do not be afraid and put it off - remember, the sooner the operation is performed (preferably within a year), the more likely it is that it will pass without any complications. The optimal age for probing is considered to be 1-3 months.

Probing procedure

So, the diagnosis of dacryocystitis has been established. So how is probing of the lacrimal duct performed in children under one year of age?

The procedure is carried out in 2 stages:

Direct probing. The baby is swaddled tightly and the head is fixed. An experienced specialist instills an anesthetic into the eye and inserts a Bowmon probe - a wire-like device with which the plug in the tear duct is destroyed and the tear duct itself expands.
Sanitation of the lacrimal system. To prevent inflammatory processes at the procedure site, antibacterial and anti-inflammatory therapy is carried out.

The whole procedure takes no more than five minutes and, in most cases, solves the problem of canal obstruction. But 40% of patients will still require repeat bougienage.

Recovery after surgery

Probing the lacrimal canal in newborns is, although not complicated, still an operation, and after it is carried out, it is necessary to follow some recommendations:

Place antibiotic drops in the eye to prevent complications.
Massage the tear ducts to completely remove the plug.
Protect your baby from colds - they can trigger a relapse of the disease.

By following all the advice of your doctor, you will protect your child from complications.

Possible risks of surgery

As a rule, probing the lacrimal duct in newborns has no consequences.

Immediately after the procedure, the child may experience bloody discharge from the nose and difficulty breathing. Anesthesia can cause headaches, nausea, and vomiting. The child may be restless and capricious. All this is normal if it goes away on the day of surgery. If symptoms continue or worsen, consult a doctor immediately.

Irritation of the mucous membrane of the eye may occur; in rare cases, conjunctivitis may develop and body temperature may increase. And although such cases are rare, it is better to know about them in order to consult a doctor in a timely manner.

In general, this operation is considered absolutely safe, since during its implementation the integrity of the skin is not violated and general anesthesia is not used. The consequences of a late visit to the doctor can be much more dangerous.

Complications

If after reading this article you are still afraid of probing your baby’s tear duct, we recommend that you familiarize yourself with the complications that may arise if you do not contact a specialist in a timely manner, most often after a year.

How the consequences of untreated dacryocystitis may occur:

corneal ulcer;
threat to the baby’s life due to developing sepsis, meningitis, and other diseases;
transition of the disease into a chronic form with serious consequences - atony, dilation, fusion of the lacrimal ducts.

Dacryocystitis is a condition of a newborn that can be easily corrected, especially at an early age. If you hear such a diagnosis from a doctor, do not panic - go through the bougienage procedure and forget about the problem once and for all.

Good day, my readers! Today I want to tell you about how probing of the lacrimal canal is performed in newborns. If you read me regularly, then you already know the causes of blockage of the tear duct. Last time I decided not to touch on the topic of bougienage, but it turned out that many mothers are interested in this topic.

So, eye probing is carried out if the child’s gelatin film does not break through, i.e. neither massage nor rinsing leads to the desired effect, and the eyes continue to constantly water, moisture or even pus accumulates in the corners, the eyelids swell and turn red.

Until now, I myself shuddered at the thought of surgery, but bougienage is more like a procedure, although it requires surgical intervention.

Typically, blockage of the tear duct occurs in small children who are 2-3 months old.

Initially the doctor:

examines the newborn;
take blood clotting tests;
will refer you for a consultation to an otolaryngologist.

When all the tests are collected together, the mother and baby are sent for probing.

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The operation does not last long, taking up to 5 minutes in total. Often, the parent is not allowed into the office, but is asked to wait in the corridor (although if you decide to have the procedure done in a paid clinic, most likely you will not be prohibited from being present).

The procedure takes place in a certain sequence:

the newborn is swaddled tightly so that the hands do not interfere with the operation, the nurse holds the head (the mother may be asked to hold the legs);
the child is given local anesthesia (a paid clinic may offer anesthesia);
then the child’s tear ducts are expanded using a certain instrument;
then a probe is inserted into the lacrimal canals (hence the name, and the probe itself is a tube that is used to rinse the eye);
At the end, the channels are treated with a solution (for disinfection).

After probing the lacrimal canal, the newborn is prescribed massage and antibacterial drops.

By the way, Dr. Komarovsky told a lot about the blockage of the tear duct, as well as about bougienage itself:

Take responsible post-operative care for your newborn. The doctor immediately warned my friend that if the recommendations are not followed, a relapse is possible.

2. Complications after surgery

And although in most cases the operation proceeds without consequences, there are children who have to undergo repeated probing.

Due to the fact that probing involves penetration of a foreign body into the lacrimal canal, it is likely that a wound will form on the inside of the eye. If the scar is not treated and preventative massage is not performed (which is a recommendation after surgery to prevent relapse), the canal may become clogged again. In this case, a repeat procedure will be scheduled.

An important point is the age of contacting a specialist. The sooner you show your child to the doctor, the greater the likelihood that the probing will be easy. With age, the gelatinous film becomes harder and harder, making it much more difficult to break.

As you can see, there is nothing wrong with bougienage, the main thing is to tune in. Do not delay in seeing a doctor; it is much easier to overcome the disease in the initial stages; sometimes a massage is enough.

I forgot to say! My friend’s child was still constantly snoring, they thought it was a peculiarity - it turned out that this was another symptom of obstruction of the tear duct (shhh, they don’t write about this on the Internet!).

3. Reviews from moms

And here is what mothers whose children have undergone a similar operation write.

Valeria:

We have already undergone this operation, in fact everything just goes away, but only my daughter was scared. This is understandable, we went to a regular clinic, waited a week for appointments, and when they arrived, they didn’t even let me into the office!!! My daughter is in shock; some strangers took her away from her mother, wrapped her in a diaper and poked her in the eye with an incomprehensible thing! But everything worked out, the disease never returned, pah-pah.

Masandra:

And I took my daughter to a paid office, everything was civilized, neat, they let me into the office, cleared her eyes in 3 minutes, prescribed eye drops for germs, showed how to do a massage correctly. One minus, the price list doesn’t say that I have to pay extra for a consultation, but I’m still happy.

Katya_Katyushka:

I also took my son, he was five months old at the time. The doctor said that I was delaying it in vain, because the film had become tougher, and it would be more unpleasant for the child than for other children. I did something, but Mityusha now has a scar in his eye, it’s clogged again, apparently I’m doing the massage wrong, or something else. In short, I’m afraid that I’ll have to go for repeat probing again. Although I read that for some time after the operation there may still be purulent discharge from the eye. I don’t know, I’ll see the doctor again soon.

My dear readers, I realized that our environment (friends, relatives, acquaintances) is a whole storehouse of information! Our friends give us precious experience through their life situations.

While listening to your grandmother’s next story on the bus, think about it: maybe her experience will help you cope with a certain problem. Subscribe to my blog to always stay up to date with all the news. Bye bye!