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Explanation of analyzes

Dacryocystitis of newborns: treatment, massage and drugs, features in adults

What it is?

Dacryocystitis is an inflammation of the lacrimal sac of an acute or chronic nature. The disease leads to a narrowing or a complete blockage of the tear duct, which in itself is a consequence of inflammation of the nasopharynx.

The outflow of fluid in the channel is disturbed, and in it the reproduction of a foreign microflora begins. The mucous membrane of the lacrimal sac becomes inflamed, and if dacryocystitis is not treated, suppurative complications of the nasal canals and even the brain ( meningitis , brain abscess, encephalitis, cyst formation and suppuration) are possible.

Lacrimal fluid is released not only during crying. Another function of tears is the constant moistening of the eyeball.

Due to this, a film appears on the surface of the eye, which prevents the mucous membrane from drying out. With prolonged work at the computer, this film dries quickly, which leads to the appearance of the "dry eye" syndrome (it is manifested by the sensation of sand in the eyes).

The main lacrimal canal is near the corner of the eye, and additional small ones in the conjunctiva itself. The main channel has two holes: one directed towards the upper eyelid, the other, respectively, to the lower one.

The last tubule contains 90% of the tear fluid that supplies the eyeball.

Content

Causes of dacryocystitis in children and adults

Newborn dacryocystitis

Dacryocystitis of a newborn is by definition congenital. At a later age, it is possible to acquire the disease due to other inflammatory processes, often localized in the head region.

Congenital causes of dacryocystitis are:

  • Violation of patency in the tear-nasal canal;
  • Presence of folded sites on the lacrimal mucosa;
  • Persistence of the fetal membrane (normally it exists only in the intrauterine period).

The causes of acquired dacryocystitis in adults:

  • Acute diseases of the nasal mucosa;
  • Systemic purulent inflammation of the conjunctiva;
  • Chronic sinusitis, inflammation of the sinuses;
  • Complications after inflammation in the eyeball;
  • Injuries of the eye and anatomical area around it;
  • Contact with a lacrimal canal of dust particles, bending eyelashes.

Dacryocystitis can occur in both acute and chronic forms with systematic exacerbations.

Symptoms of dacryocystitis in newborns

Symptoms of dacryocystitis in newborns

a photo

In the first months after birth, the eye of the child should be abundantly washed with a tear. While the fetus is in the womb, the area around his eyes is filled with gelatinous viscous masses. The entrance to the tear duct itself is covered with a membrane. Quite often in the third trimester against a backdrop of malohydration, the membrane can coalesce with the tear duct, which provokes blockage.

On the 7th-10th day, parents notice the following symptoms of a newborn's dacryocystitis (see photo):

  1. Spontaneous purulent discharge or discharge when pressing on the area near the tear duct (normally a small opening at the inner corner of the eye is visually defined;
  2. Redness and swelling of the skin around the inner corner of the eye;
  3. Constant copious lacrimation, uncharacteristic for a child younger than 4 months.

Inflammation in most cases is one-sided in children and adults of any age. If redness in a newborn is bilateral - the process is characterized by a greater severity of the flow.

Dacryocystitis is easily confused with conjunctivitis due to the similarity of symptoms. However, with inflammation of the conjunctiva, there is a noticeable reddening of the entire eyeball, swelling around the eye and various substances of excretion. Conjunctivitis of a newborn is often a two-way process.

The gelatin film itself can dissolve itself in 2-3 weeks, and the inflammation will subside. Otherwise, the child needs treatment to prevent complications from the brain and nasopharynx.

Dacryocystitis in an adult

Dacryocystitis in an adult

Dacryocystitis in adults can be a consequence of complications after inflammatory processes in the eyes, nasal sinuses and brain (the causes listed above).

Often, the nature of adult dacryocystitis is chronic, because the symptomatology of the disease is not bright, and the patient is in no hurry for medical help. As a result, the inflammatory process passes into a chronic form.

In the tear duct due to fluid stagnation, pneumococci and staphylococci multiply, for this reason, clear or yellowish pus is released from the inflamed sac.

At the first stages of the disease visually does not produce itself. Near the inner corner of the eye, there is a flaring, itching, then there is a swelling. Copious lachrymation is accompanied by pain.

The last stage of inflammation development is reddening around the corner of the eye and growth of swelling up to 2-3 cm, which leads to a mechanical overlap of some fields of vision.

Treatment of dacryocystitis in newborns, massage and drugs

If a small patient has been diagnosed with dacryocystitis, the treatment will consist of several stages (depending on the age of the patient).

Before the appointment of a course of massage and medications, an ophthalmologist must perform a control diagnosis. It is more actual for newborns, since there is a possibility of taking a more dangerous disease for dacryocystitis.

After a classical examination, if a specialist has doubts about the patency of the patient's lacrimal ducts, a 2% solution of collargoll is instilled. This drug has a coloring property. If the tear duct is all right, after 2-3 minutes the color that is not characteristic of the eyeball will disappear, because the drug will enter the canal. When this occurs, this does not happen.

The quality of passage of the tear duct is checked by a cotton swab that is brought to the conjunctiva. If traces of the coloring matter is not found, there is no problem with the passage.

10 minutes after instillation, the tampon is inserted into the nasal cavity, under favorable conditions (in the presence of patency), it should be colored. If the diagnosis is confirmed, the patient is prescribed a therapeutic massage.

Massage

Treatment of dacryocystitis in newborns

Massage in the newborn's dacryocystitis is made by the mother, who was previously trained by an ophthalmologist. The localization of the lacrimal sac must be determined through the skin - it is located next to the inner corner of the eye. Massage is performed daily immediately after feeding the baby.

It is necessary to grope for the tear sack and with your finger, pressing lightly, hold up and down up to 10 times. Confirmation that you correctly identified the localization of the problem area, will serve as the selection of pus.

During the massage, the mother must follow the rules of hygiene: hands should be washed or disinfected with an antiseptic (if the child does not have an allergy to it). Long nails are also prohibited, because there is a risk of damaging the child's eyeball.

But you need to press on the bag with reasonable effort, otherwise from manipulation there will be no effect. The younger the patient, the more effective the massage will be.

The function of the massage is to mechanically clear the tear ducts from the pus. After 8-10 movements up and down, it is necessary to rinse the eye to remove the remaining pus from the mucous membrane.

It is best to treat the eyeball with a solution of furacilin. For its preparation, put one tablet of the drug in a glass of boiling water, dissolve and cool.

Massing movements should be smooth, directed from the outer corner of the eye to the inner. , отдайте предпочтение ватным. Marl tampons make cleaning of mucous membranes impossible , give preference to cotton. The reason is that the gauze threads easily adhere to the wet surface, and it is extremely difficult and painful to remove them from a newborn baby.

After the eyeball is cleaned, it is necessary to drip the eye with an antibacterial or antiseptic drug. For children at an early age, this drug Levomycetin (0.25%): you need to drip at least 5 times a day. Often the child transfers all the procedures normally.

Treatment of dacryocystitis in newborns lasts no more than 14 days, in most cases recovery occurs after a two-week period.

Sounding

Treatment of dacryocystitis

If after 2 weeks the inflammation has not passed, but on the contrary, continues to progress, the ophthalmologist appoints the next stage of treatment of dacryocystitis in newborns - probing of lacrimal canals.

As a rule, at this time the child's condition is characterized by an increase in temperature to 38 ° and leukocytosis. To perform the procedure, you need a general blood test with coagulation rates and a conclusion from the pediatrician.

The ophthalmologist makes the baby a local drip anesthetic, often this is enough to not feel pain. Curing dacryocystitis, sounding is called a 100% method of struggle, because with this procedure it can be guaranteed to eliminate all "clogging" of the tear duct.

Despite the introduction of anesthetic drops, the child behaves restlessly, but, as practice shows, comes to emotional balance immediately after the end of manipulation.

The probe is inserted into the lacrimal duct and runs along its entire length, clearing from all "blockages" and eliminating constrictions. The procedure passes very quickly and the discomfort near the eye passes after several hours. Ophthalmic manipulations are completed with the instillation of an antibacterial drug in the tear duct.

Preparations

Therapy with antiseptic drugs is prescribed for a period of 7-10 days, after which the doctor conducts a second examination, and in the presence of pus or contamination of the ducts, sounding is re-assigned.

According to statistics, repeated treatment of dacryocystitis is indicated in patients in 20-25% of cases. The method and duration of therapy largely depends on the timeliness of the reference to the ophthalmologist.

Treatment of dacryocystitis in adults

Dacryocystitis in adults can often not be cured by massage as an independent method. As a therapy, the patient is assigned to wash the tear duct with antibacterial and anti-inflammatory solutions: Dexamethasone, Floxal, Ciprofloxacin and Levomycetin. Also, the use of vasoconstrictive drugs is acceptable.

Most often, in the treatment of dacryocystitis in adults, one or more probing procedures are used to purge the lacrimal canal from purulent substances. Narrowing of the duct in adults is virtually impossible, and the disease is bacterial in nature.

The procedure for insertion of the probe is performed under local anesthesia and does not bring painful sensations. 10-15 minutes after probing the patient can leave the clinic and go home.

Traumatic and chronic dacryocystitis in adults, and in some cases in children, requires surgical intervention - dacryocystorhinostomy. If the disease progresses, and the tear duct can not be cleaned by sounding, the ophthalmologist assigns this operation.

The purpose of surgical intervention is to create a new way for the drain of tear fluid into the nasal cavity, during the procedure, the tear sack is also cleaned. The classical operation is performed with an external cut. Among the disadvantages of such treatment of dacryocystitis in adults is the formation of adhesions on the mucous membranes and the presence of a visible suture from the bridge of the nose to the corner of the eye.

Modern medicine offers a method of microsurgical intervention - the formation of anastomosis. The operation is performed through the nose, and the formation itself is formed by means of radio wave action.

Thus, dacryocystorhinostomy is performed without damage to the skin, and therefore, cosmetic defects on the face are excluded.

After the operation, the patient is assigned sulfonamides, antibiotics and visits to physiotherapy procedures. Relapses after such a surgical intervention are extremely rare.

Forecast

Treatment of dacryocystitis is almost always successful, except for cases when you see a doctor late in the course of the disease progression.

Complications can be inflammation of the brain tissue and nasopharynx. If the treatment of complications is neglected, weakened patients rarely develop sepsis , which will lead to a fatal outcome.

Interesting

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