Inflammation of the tear ducts treatment. Dacryocystitis in adults: treatment

Dacryocystitis is medical term, indicating inflammation of the tear duct. Its root cause is obstruction of the glands, as a result of which fluid enters the tear ducts into the sinuses and stagnates there.

This causes active reproduction harmful microorganisms and development of the inflammatory process.

Relevance of the problem

Layout of tear ducts

The lacrimal duct is located in a small hole next to outer corner eyes. This pouch is part of the so-called lacrimal system, the main function of which is to remove tears from the eye area into nasal cavity.

Dacryocystitis occurs in approximately seven percent of all diseases of the lacrimal system.

The problem of inflammation of the tear duct is especially common in women.

Experts attribute this to different structure and the size of the tear ducts in women and men.

Causes of the disease

Dacryocystitis is a disease that can be caused by both congenital and acquired factors.

Moreover, there can be a huge number of them; it is not always possible to establish these reasons accurately. The following factors can provoke the development of the disease:

• Severe hypothermia or, conversely, overheating of the body;
• Allergic reaction;
• Received injury to the eyes or nose;
• Weakened immunity;
• Infectious diseases, as well as complications after them;
• Foreign body getting into the eye;
• Impaired metabolism;
• Working with substances that irritate the eye membrane, or long stay in very dusty rooms;
• Advanced inflammatory process in the sinuses;
• Availability diabetes mellitus or other chronic diseases.

Some experts even believe that you can determine the likelihood of developing the disease by appearance. In their opinion, the risk group includes people belonging to the Caucasian race, with a narrow nose, flat face and a certain head shape.

Dacryocystitis in children can appear even immediately after birth. This is due to the peculiarities of the development of tear ducts in infants. So, even before the baby is born, his tear ducts are covered with a protective membrane.

In the presence of any pathologies, such a membrane may remain after birth, which leads to the accumulation of tear secretion and the development of the disease. This pathology is especially common in premature babies.

Prevalence in adults

As for adults, this disease can be caused by physiological reasons. Thus, tear ducts can be narrowed or completely blocked from birth.

This disease occurs more often in women than in men. The triggering factor is often overuse cosmetics, which also causes inflammation of the tear duct.

In older people, the disease can even cause vascular atherosclerosis. Bad cholesterol can be deposited even in openings as small as lacrimal ducts. In this case, you can help by washing your eyes under a strong pressure of furatsilin solution.

In addition, it often happens that the eyes become very watery during the cold season, when strong wind or in the cold. The fact is that the cold itself causes spasms of the tear ducts. If a person also has such a channel narrowed from birth, tears can simply flow in a stream.

A good solution here would be regular glasses. They support normal temperature, creating a comfortable environment. It’s not for nothing that dacryocystitis practically never occurs among people who wear glasses.

Main symptoms

For successful treatment disease, it is important to identify it early stage. The following symptoms are characteristic of dacryocystitis:

1. Inflammation usually occurs in only one eye;
2. There is constant and strong lacrimation;
3. Increased fatigue;
4. Frequent dizziness;
5. Swelling and redness near the lacrimal sac;
6. Constant pain around the affected area. It's a dull pain may be replaced by acute ones painful sensations during touch;
7. Poor appetite;
8. The appearance of ulcers and discharge from them;
9. Swelling of the eyelids. Because of this, the palpebral fissure begins to narrow, and the person sees worse;

In adults, blood pressure may increase. In addition, due to the development of the inflammatory process, general intoxication of the whole body occurs: the patient experiences severe weakness, gets tired quickly, and his ability to work is significantly reduced.

Dacryocystitis in a child can be identified by swelling of the eyelids and discharge from the lacrimal canals. If the disease is not recognized in time, the eyes will begin to water, and as inflammation develops, tears can flow constantly. You can see what the disease looks like in photos on the Internet.

Possible complications

Inflammation of the ducts can occur in people of different ages. This disease is especially dangerous because during an exacerbation, phlegmon of the lacrimal canal may appear. Externally, it looks like swelling, swelling and redness under the lower eyelid. Sometimes it is not given much importance, but phlegmon can open both outward and inward. In this case, pus will enter the ducts, and through them into the eye socket. The consequence of this may be the spread of purulent discharge in the cranial cavity, which causes the most severe consequences up to brain damage and blindness.

In addition, inflammation of the tear ducts can cause dropsy in the eye, which will require surgical intervention.

Therefore, if any symptoms appear, you should immediately contact an ophthalmologist to make a diagnosis and begin treatment for the disease.

Diagnostic methods

For a practicing physician, diagnosing the disease is usually not very difficult; its symptoms are too specific. Therefore, a visual examination is sufficient to make a diagnosis, but a comprehensive examination is usually performed. Detection of the presence and form of the disease is possible using in various ways diagnostics:

• General blood and urine analysis;
• Taking a smear to determine bacterial microflora;
• Examination of the patient's eye under a microscope;
• X-ray, which is carried out by injecting a special dye into the eye ducts;
• Rhinoscopy. It allows you to identify not only the presence of pathologies in the nasal sinuses, but also determine what diseases could lead to obstruction of the canals;
• Sometimes a special substance is dropped into a person’s eyes, and the sinuses are closed with a tampon. If drops of this substance do not appear on the tampon, then the patient has canal obstruction.

Dacryocystitis in children is detected using the same methods.

However, treatment is prescribed only after a thorough study of all symptoms and complete comprehensive examination patient.

Treatment of the disease in adults

The doctor will treat the disease taking into account factors such as the person’s age, the form of the disease (acute or chronic), as well as the reasons that caused it. First of all, it is compiled individual plan treatment.

If the disease is acute, the doctor will often prescribe antibiotics. In addition, painkillers may be prescribed (as a rule, these are medications included in the analgesic group), as well as antihistamines which help relieve swelling. Sometimes UHF and vitamin therapy are prescribed. If suppuration has formed, you need to remove the abscess and treat the wound well with an antiseptic.

If the acute form of the disease has become chronic, surgery may be prescribed. The most common operative method– dacryocystorhinostomy, which allows you to establish an additional connection between the nasal sinus and the lacrimal canal. As a result of applying this method purulent discharge stop accumulating and the outflow of fluid normalizes.

In addition, bougienage can be performed, which helps cleanse the tear ducts from accumulated pus. After such an operation, there will be no stagnation of tear fluid, and the patency of the ducts will gradually normalize.

Particular attention in the treatment of dacryocystitis is paid to washing. Many clinics provide this service; its duration ranges from half an hour to several hours.

Regarding methods traditional medicine, they can only be used after consulting a doctor. Such remedies are aloe juice, which is diluted in half with water and instilled, as well as eyebright juice. Thyme is also used: it is steamed and infused for several hours. Then it must be strained and instilled three times a day. Good action Compresses made from a decoction of chamomile or calendula are applied two to three times during the day.

To prevent the development of the disease, you must first protect your eyes from hypothermia and irritation, and also strengthen your immune system.

Features of treatment for children

Dacryocystitis in children has its own specific treatment. First of all, if your baby develops the corresponding symptoms, you should not try to solve the problem yourself. Sometimes parents try to cope on their own, buy drops from pharmacies without a doctor’s prescription, simply using their intuition and the advice of a pharmacist, and put on various lotions. Sometimes these remedies really help for a while. However, then the eyes begin to fester and water again. So since you don't know accurate diagnosis child and what to do in this case, you will only waste time, and complications may arise.

After diagnosis, the doctor will prescribe special therapy for the child. So, massage is very often used. It cannot be done only under the most running forms disease, because there is a possibility of blood flowing into soft fabrics, which is fraught with blood poisoning.

First of all, the specialist will try to massage the child for several days to break the eye membrane. If this cannot be done, bougienage can be carried out. It involves cutting the membrane using a very thin rod. Then the eyes are washed with medicinal solutions.
If, as a result of obstruction of the canal, the eye sac becomes inflamed, it is useful to wipe sore spot a napkin soaked in chamomile infusion. This plant has a good antibacterial effect.

Surgical intervention is used only in cases where therapy for a long time does not bring results. The operation takes place under anesthesia; before it the baby is treated antibacterial type to avoid complications during surgery.

Proper massage

A mother can give a massage to a child, but a doctor must teach him the technique. This massage consists of the following stages:

• First of all, you need to thoroughly disinfect your hands. To do this, they are washed with soap and treated with an antiseptic solution. You can also carry out procedures with gloves;
• Then, using a cotton swab soaked in a solution of furatsilin, squeeze out the pus and other secretions that have accumulated in the child’s eyes. Now you can start the massage itself;
• Massage should be done four times a day, preferably before feeding. At the same time, you should not put pressure on the child’s eyes. It should be done with light circular movements, trying to squeeze out the discharge;
• After finishing the massage, you need to wipe your eyes with a cotton swab treated with an antibacterial solution and drip drops for disinfection.

Conclusion and conclusions

So to avoid negative consequences with dacryocystitis, treatment should be started as early as possible, as soon as you notice similar symptoms. If you follow all the doctor’s recommendations, follow preventive measures and protect yourself from hypothermia, you will definitely defeat this unpleasant and dangerous disease.

If you've recently watched crying baby or the latest sentimental Hollywood movie - you are well aware that tears are running down your face

However, we also have a tear duct (also called the "nasolacrimal duct" and "tear duct"). through which tears pass through the nose. These drainage tubes cause a runny nose when crying or an allergic reaction in the eyes.

When the tear duct becomes blocked, problems arise. Let's look at the causes of blocked tear ducts, how it happens and how to get rid of it.

Why does blockage of tear ducts occur?

Blocked tear ducts occur for many reasons.

Congenital blockage: One fifth of all babies are born with blocked tear ducts. This may be caused by an underdeveloped or abnormal canal or problems with the development of the facial and cranial structure.

Age-related narrowing of the tear ducts: In adults, the opening of the tear duct may narrow, increasing the likelihood of a blocked tear duct.

Infections and inflammation: Infections and inflammation of the tear duct, eyes and nose can also cause blocked tear ducts. A blocked tear duct itself can lead to infection and inflammation.

Bruises and facial injuries: Any bruises that affect the tear ducts and the bone structure around them can lead to a blocked tear duct.

Tumors, cysts and stones: Blocked tear ducts can be caused by tumors and other growths.

As you can see, while a blocked tear duct produces a variety of symptoms, it can also indicate primary disease. Always consult your eye doctor for eye problems so that they can provide timely assistance.

Symptoms of blocked tear ducts

Blocked tear ducts or an infection caused by the blockage can present with a number of symptoms. This includes:

• Watery eyes and excessive tearing
• Repeated inflammation and infections (infections may be caused by the blockage or lead to the blockage)
• Buildup or secretion of mucus
• Pain and swelling in the corners of the eyes
• Blurred vision
• Bloody tears

Your ophthalmologist will be able to evaluate the function of the tear duct drainage and determine treatment options.

Treatment of blocked tear ducts

The best treatment for blocked tear ducts depends on the cause. Your eye doctor will recommend trying the least invasive option first and then choosing what works for you and when to move on to other treatments.

Below are common treatments for blocked tear ducts.

Blocked tear ducts in babies

For many newborns, tear duct blockage resolves during the first year of life. However, there are cases when treatment is necessary. The first treatment for blocked tear ducts in infants involves dilation (gently widening the duct), probing, and lavage. If this does not help, the ophthalmologist will sometimes insert a dilation probe to further widen the canal.

Blocked tear ducts in adults

Blocked tear ducts in adults usually indicate narrowing or other problems that do not go away on their own. The first stage of treatment is the same as for infants: dilatation, probing and lavage.

If there is no response to less invasive treatment, surgical stenting and intubation are performed by inserting a tube to keep the tear duct open.

As always, you should talk to your eye doctor if you are experiencing symptoms or concerns. Your ophthalmologist regularly examines your eyes and also looks for problems between regular checkups, and helps you choose best practices treatment.

The lacrimal or lacrimal ducts have a complex and rather tortuous structure, where there are “dead ends”, that is, closed spaces, as well as narrow areas. Quite often, along this difficult “route”, peculiar traffic jams form that disrupt the natural outflow of tears. The narrow nasolacrimal duct does not allow fluid to enter the nasal cavity, and as a result, it begins to accumulate in the lacrimal sac, thereby causing stagnation of tears, which creates optimal conditions for the development of pathogenic microorganisms and the onset of the inflammatory process.

In ophthalmology this pathology called dacryocystitis. This dangerous disease, which without proper and timely treatment can lead to serious complications, up to meningitis and brain abscess.

What factors provoke inflammation? How to recognize the disease? What to do if dacryocystitis occurs? Let's figure it out together.

What causes eye disease?

There can be many reasons for the development of the inflammatory process. Conventionally, they can be divided into two main groups: congenital and acquired.

The first include congenital anomalies of the lacrimal apparatus (narrowness of the canal, persistence of the fetal membrane).

Ophthalmologists include the second group:

• injuries to the nose or eyes;
• inflammatory processes in the sinuses;
• bacterial and viral infections;
• purulent conjunctivitis;
• contact with foreign particles (dust, eyelashes, etc.) in the eyes.

In young patients, that is, children, it is more common congenital anomaly. But in adults, the disease usually develops against the background of injuries or various diseases. It is worth noting that women are more susceptible to this pathology than men, and this is due to some structural features of the lacrimal apparatus, as well as the use decorative cosmetics, which can also provoke the development of the inflammatory process.

Whatever the reason ocular pathology, you cannot do without competent therapy, so when the first alarming signs appear, you should immediately rush to see an ophthalmologist.

Symptoms of the disease

Eye pathology can occur in acute and chronic forms. Depending on the type of disease, clinical symptoms have different manifestations.

However, both acute and chronic forms have general signs: profuse lacrimation, discharge of pus from the affected eye and swelling. If treatment is not started in time, the inflammatory process can spread beyond the lacrimal sac. In this situation general symptoms will be complicated by severe swelling and severe pain.

As for the chronic form of the disease, in addition to the main symptoms, additional symptoms may appear: swelling of the eyelids, inflammatory reaction conjunctiva, increase in the size of the lacrimal sac.

Symptoms acute form ocular pathology has a more pronounced manifestation:

• redness and swelling of soft tissue in the area of ​​inflammation;
• pain when blinking and palpating;
• narrowing or complete closure of the palpebral fissure;
• increased body temperature;
• chills;
• Strong headache.

How to treat inflammation of the tear duct?

When we're talking about about the organ of vision, then there can be no talk of any self-medication. When the first signs of illness appear, rush to the doctor immediately. Only a specialist will be able to conduct a competent diagnosis, adequately assess the degree of inflammation, examine the affected areas, and after receiving all the examination results, prescribe appropriate treatment. Therapeutic methods depend on many factors: form and causes pathological process, as well as the age and health of the patient.

Here are the main methods of treating eye pathology:

• washing the lacrimal canals with special disinfectant solutions;
• use of medicinal ointments and drops;
• massage and warm compresses (only possible for chronic dacryocystitis).

Regarding washing the tear ducts with antiseptics, they are done several times a day. This may be a solution of Furacilin, Boric acid and so on. The procedure is carried out only in outpatient setting and only by an ophthalmologist who has special skills for this.

Also, along with rinsing, the patient is prescribed ointments and drops that have an antibacterial effect, for example:

• Phloxal- an antibacterial agent that relieves inflammation. The medicine is used for no more than two weeks, 1-2 drops twice a day.
• Dexamethasone- antibacterial drops that are used for infectious lesions. They are used 3 to 5 times a day. The dosage of the drug and the duration of treatment should be prescribed exclusively by a doctor.
• Levomycetin- hormonal drops which are used for allergies and inflammation visual organ. The medicine is instilled into the eye sac three times a day.
• Ciprofloxacin - antibacterial drug. It is used for infectious lesion eyes, as well as for chronic inflammation of the lacrimal canal. The medicine is used every 4 hours, 1-2 drops.

It is worth noting that all drugs have many contraindications and restrictions, so only an ophthalmologist should prescribe them.

If drug therapy does not produce desired effect, then the patient can be prescribed surgery, including bougienage (cleaning the tear ducts from accumulated purulent contents) and dacryocystomy (an operation by which the doctor forms a valve in tear duct, which prevents further accumulation of purulent masses).

For inflammation of the lacrimal canal it is also often used folk remedies, but only after medical approval. For example, you can use freshly squeezed aloe juice, diluted with saline in a 1:1 ratio - 2 drops per affected eye.

Also very effective in the treatment of dacryocystitis chamomile infusion. The herbal medicine can be used to wash the infected area or use it instead of drops. Preparing the healing liquid is simple: pour a teaspoon of dry raw material into a glass warm water and boil the liquid in a water bath for 10 minutes. Then strain the cooled broth and use it to treat the eyes.

In conclusion, I would like to remind you once again that treatment of eye disease will be quick and easy if it is started in a timely manner. Therefore, when the first symptoms occur, do not delay visiting a specialist and under no circumstances self-medicate.

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Obstruction of the lacrimal duct in newborns occurs, according to various sources, in 7-14% of children.

This is a condition in which the normal outflow of tear fluid is disrupted due to complete or partial blockage of the tear duct.

The structure of the nasolacrimal duct in a newborn baby

Tear fluid performs several important functions:

• Protects the eye from drying out;
• Participates in the refraction of light;
• Forms the tear film;
• Nourishes the cornea.

Tears are produced by a gland located in the lacrimal fossa at the upper outer edge of the eye socket. First, it enters the conjunctival cavity, and then, along the lacrimal canaliculi, into the lacrimal sac, located near the inner corner of the eye. Excess tears exit through the nasolacrimal duct into the nasopharynx.

In newborns, the nasal canal is relatively short - only 8 mm, whereas in adults the length of the canal ranges from 14 to 15 mm. This creates favorable conditions for infectious agents to enter the lacrimal sac. In addition, the lacrimal canal in newborns is underdeveloped, which also contributes to the invasion (penetration) of microorganisms.

Mechanism of obstruction formation

The entire period of intrauterine development, the nasolacrimal canal is covered with a thin film, which prevents amniotic fluid from entering the nasopharynx. However, as the baby passes through the birth canal or with the first cry, this film breaks and frees the entrance to the nasolacrimal canal. If this does not happen, dacryocystitis develops - inflammation of the lacrimal canal caused by fluid stagnation.

The first sign of obstruction of the lacrimal canal in an infant is increased tear production. If in the first weeks after birth the patency of the canal is not restored, infectious agents (viruses or bacteria) penetrate into the lacrimal sac and purulent inflammation develops.

In some babies, the tear film may rupture on its own within the first six months to a year. This is due to the growth and expansion of the nasolacrimal ducts, as a result of which the film stretches and ruptures on its own. All this time, the child should be under close supervision of an ophthalmologist. At correct observance All medical recommendations for inflammation of the lacrimal sac can be avoided.

Reasons for formation

The following factors can lead to obstruction of the nasolacrimal duct:

• Partial or complete absence nasolacrimal duct;
• Anomalies in the development of the lacrimal sac (for example, the presence of diverticula - pathological outgrowths);
• Incorrect location of the lacrimal sac;
• Traumatic damage to the lacrimal ducts (for example, due to careless obstetric manipulations);
• Congenital narrowness of the nasolacrimal duct;
• Deviated nasal septum and other anomalies in the structure of the nasal cavity;
• Dacryocystocele is hydrocele of the lacrimal sac.

Symptoms of obstruction

Obstruction of the nasolacrimal duct can be detected even in maternity hospital. However, in most cases, this problem makes itself felt much later.

The very first sign of the disease is the appearance of causeless lacrimation in the baby.. Moreover, it can be either unilateral or bilateral (in the case of simultaneous damage to both eyes).

Some time after tears appear, the eye begins to turn red and dacryocystitis develops. In this case, stagnation of tear fluid is formed, which is favorable condition for the attachment of bacteria and their further reproduction.

Purulent discharge appears, which may be accompanied by sticking of eyelashes and an increase in temperature. The causative agents of dacryocystitis are usually streptococci, coli, staphylococci, less often - chlamydia and gonococci.

Sometimes indicated symptoms are mistaken for . However, conjunctivitis, unlike dacryocystitis, often has bilateral localization. In addition, there are a number of other diagnostic signs, allowing to differentiate these conditions. More details about them are described in the “Diagnostics” section.

When pressing on the lacrimal sac, drops of cloudy purulent liquid are released from the lacrimal openings. Largest quantity Such discharge is observed after the baby wakes up or during strong crying.

As dacryocystitis progresses, ectasia of the lacrimal sac occurs - its stretching and increase in volume. At the same time, the skin over it is hyperemic (red) and sharply stretched. In particular advanced cases the bag can reach the size of a ripe cherry.

Overstretching of the mucous membrane of the lacrimal sac leads to its atrophy and inability to produce mucous secretion.

Diagnosis of lacrimal duct obstruction

Diagnosis of dacryocystitis in infants is based on anamnesis (questioning the mother about the course of the disease) and use additional methods research:

Comprehensive diagnostics must necessarily include a detailed clinical analysis blood and urine, as well as consultations related specialists(pediatrician, ENT doctor) to exclude other diseases.

Treatment of lacrimal duct obstruction in newborns

Under no circumstances should you start self-treatment dacryocystitis in newborns at home. And even more so, you don’t need to listen to the advice of grandparents, experienced neighbors and others. This may lead to serious consequences(transition of the disease to chronic form, phlegmon of the lacrimal sac, phlegmon of the orbit).

There are several tactics for managing a newborn who has been diagnosed with obstruction of the nasolacrimal duct: conservative (expectant) and surgical. Let's look at each direction in more detail.

Medicines

In parallel with the massage, the doctor may prescribe antibacterial agents to prevent infection. The choice of antibiotic directly depends on the results of microbiological testing.

Usually these are eye drops that need to be instilled into the conjunctival cavity several times a day after a massage.

good antibacterial effectiveness have the following drugs: Vigamox, Tobrex, chloramphenicol (0.3%), Oftaquix, gentamicin (0.3%).

Contrary to popular belief, the use of albucid is undesirable for a baby for two reasons:

• When instilled it causes a burning sensation;
• It is characterized by crystallization (precipitation). And this can further aggravate the obstruction of the nasolacrimal duct.

If the doctor prescribed several medicines, they need to be instilled with a break of at least 20 minutes.

Operation

If conservative methods treatments do not have the desired effect, there is a need surgical treatment- probing the nasolacrimal duct. At the same time, the opinions of doctors regarding the timing of this manipulation differed.

Some believe that the most optimal time falls on the 4th – 6th months of the baby’s life. Others believe that probing should be resorted to after two months of unsuccessful conservative therapy. In any case, the timing of the sounding will be selected individually depending on each specific case.

Before the operation, the baby must be examined by an ENT doctor to rule out concomitant diseases.

Probing of the nasolacrimal duct is performed by a pediatric ophthalmologist in a clinic setting. As a rule, local anesthesia is used.

The baby is swaddled tightly and his head is fixed by a nurse. First, the nasolacrimal canal is expanded using a conical Siegel probe, which is inserted into the lacrimal punctum.

Then a long Bowman probe is inserted into the canal, which pierces the embryonic membrane. After this, the canal is washed with some disinfectant solution. Probing takes only a few minutes and is absolutely safe for the baby.

In 30% of cases, the manipulation may need to be repeated.

Statistics show that probing allows you to restore the patency of the nasolacrimal duct in 90% of cases.

WITH for preventive purposes After the intervention, the child is prescribed antibacterial drops, UHF and massage.

If the operation is unsuccessful, the cause of the obstruction lies in intrauterine developmental anomalies (for example, due to a deviated nasal septum). Then something more serious may be required. surgery.

Massage of the lacrimal canal in newborns

Massotherapy: Usually conservative treatment begins with a massage of the lacrimal canal in a newborn. This is necessary in order to facilitate the rupture of the film and, thus, restore the patency of the nasolacrimal duct.

The sooner the mother starts massage, the higher the chances of recovery without surgery. The fact is that with age the film becomes much denser, and it will be more and more difficult to break through it with the help of massage.

The doctor performs the first massage of the nasolacrimal duct in newborns on his own to teach the mother the correct technique.

It was found that correct execution massage allows you to restore the patency of the lacrimal canal in a third of children whose age has not exceeded 2 months. With each subsequent month, the likelihood of the film breaking on its own decreases.

Rules for massage for obstruction of the lacrimal canal in newborns:

• Wash your hands before the procedure boiled water with soap, clean your nails thoroughly and cut them short;
• The pus that will come out when pressing on the lacrimal sac must be removed with a sterile gauze swab soaked in furatsilin or chamomile decoction;
• Try to remember all the doctor's recommendations regarding massage, especially the strength with which to apply pressure. Stroking too lightly will have no effect, while too much stroking may harm the baby.

How to massage the tear duct for a baby:

Massage for blockage of the lacrimal canal in newborns should be repeated 4-5 times and performed at least six times a day. Now you know how to properly massage the lacrimal canal for dacryocystitis in newborns.

It is best to massage while the baby is crying.. The fact is that then the child tenses all his muscles, especially facial muscles, which can contribute to the rupture of the embryonic film.

Blocked tear ducts interfere with the healthy flow of tear fluid. This can lead to the development of an inflammatory process. The disease occurs more often in women (especially older people). The causes of pathology may be congenital features, injuries, diseases. Symptoms become more pronounced as the disease progresses. Effective methods Treatments for inflammation of the lacrimal duct are: application medications, bougienage, surgical intervention.

• Show all

  Reasons for appearance

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

  The causes of tear duct obstruction include:

  • Congenital pathology of patency. Underdevelopment of the system at birth is manifested in the blockage of the canal with a tear plug. The defect may disappear on its own in the first months of life. If this does not happen, then medical intervention is required.
  • Abnormal development of the skull and face (for example, in patients with Down syndrome).
  • Age-related changes. In older people, the tear ducts narrow (stenosis), which leads to their blockage.
  • Infectious diseases and inflammatory processes occurring in the area of ​​the visual organs ( chronic inflammation eyes, tear ducts, nose).
  • Surgical operations performed on the eyes.
  • Injuries. Various facial injuries can affect the bones adjacent to the tear ducts. The bones become dislodged and interfere with the normal flow of fluid.
  • Tumors on the face. Formations that arise in the nose, bones, and lacrimal sac can block the canal. This occurs if the tumors increase greatly in size.
  • Formation of cysts and stones in drainage system(disturb the outflow).
  • Medicines for external use. Some eye drops provoke obstruction of the tear ducts.
  • Medicines internal use. Obstruction occurs as by-effect from taking certain medications (for example, Docetaxel, a medicine used to treat breast and lung cancer).
  • Irradiation. If a person has suffered cancer, during treatment of which radiation was used, the risk of developing a blockage increases.

  

  

  Symptoms of the disease

  The blockage can occur in one or both eyes. Inflammation of the lacrimal duct in adults is accompanied by the following symptoms:

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

  On initial stage the disease manifests itself weakly. The patient feels discomfort and a feeling of fullness in the lacrimal sac. After some time, against the background of constant lacrimation, strong pain and redness of the skin.

  

  Diagnostics

  To confirm the preliminary diagnosis, the ophthalmologist examines the patient and prescribes tests. These include:

  • Dye test. A dye solution is instilled into the patient's eyes. If within the next few minutes there is a large number of dye in the eye, this indicates that the channel is clogged.
  • Channel sounding. Using a thin instrument, they penetrate the lacrimal canal. The problem may be resolved after the procedure, as the canal expands during probing.
  • Dacryocystography. X-ray of the lacrimal canals with the introduction of a dye into them. Using this method, an image of the outflow system of the eye is obtained.

  

  Treatment

  Therapy for the disease depends on the cause that triggered its development. To combat the disease the following is used:

  1. Antibiotic therapy. If the disease is caused by an infection, then antibiotics are used (Ciprofloxacin, Levomycetin, Erythromycin).

  2. Bougienage. The treatment method is more gentle than surgery. To carry out the procedure, a special probe is used - a bougie. It is administered through the lacrimal opening. The device removes obstacles mechanically (cleaning is performed) and expands the channels. The method of therapy is painless, but accompanied unpleasant sensations. Sometimes, before bougienage, the patient is given intravenous anesthesia. The procedure lasts several minutes. In advanced cases, it may need to be repeated; it is carried out at intervals of several days. Sometimes bougienage is performed using synthetic elastic threads or hollow tubes.

  3. Eye drops. Blocked tear ducts are successfully treated using:

  • Phloxal. The drops have an antibacterial effect. Active substance They contain the antibiotic ofloxacin. One drop is instilled into the lower conjunctival sac up to four times a day. Floxal ointment is often used. It is placed under the lower eyelid up to three times a day. Allergic reactions are a contraindication to treatment with this drug.
  • Gentamicin. Antibiotic eye drops. Apply one or two drops up to four times a day. Contraindications include: serious illnesses kidney, neuritis auditory nerve, hypersensitivity to the ingredients of the drug.
  • Oftalmoferon. Antiviral eye drops. Instill one or two drops up to eight times a day during acute inflammation, then up to three times a day. Contraindications include increased sensitivity on any of the components of the drug.

  Other eye drops may also be prescribed (Furacilin, Vitabact, Vigamox, Tobrex).

  Radical ways to fight

  Surgical intervention is prescribed in advanced cases and if the cause of the inflamed canal is the formation of a tumor. Two types of operations can be performed:

  • Endoscopic dacryocystorhinostomy. During the surgical procedure, a flexible endoscope with a camera is inserted into the tear duct. Using an endoscope, an incision is made in the affected tear duct. The operation is available to patients who do not have allergic reactions for anesthetic agents. Rehabilitation period lasts up to eight days. To exclude the occurrence inflammatory processes in the cornea, antibiotics are prescribed. The advantage of endoscopic dacryocystorhinostomy is that after it is performed there are no visible scars left on the skin and the tear ducts are not damaged.
  • Balloon dacryocytoplasty. A safe surgical intervention that can be performed even on children under one year old. IN nasolacrimal duct A thin guide is inserted through the corner of the eye. It is equipped with a cylinder filled with a special liquid. At the site of blockage, a pressure balloon expands the problem area of ​​the tear duct and helps clear it. The device is then removed from the eye. When carrying out the procedure, use local anesthesia. A patient who has undergone balloon dacryocytoplasty is prescribed a course of antibiotics and eye drops.