Symptoms of dacryocystitis and methods of treating inflammatory pathology

Dacryocystitis is an inflammation of the lacrimal sac, which usually has a chronic course. Most often, this disease affects newborn children and people over 30 years of age, especially women. There are several types of dacryocystitis. Let's look at the reasons why it can occur, as well as ways to effectively treat the disease in adults and children.

Tear fluid is an essential product for the normal functioning of the eye. It is constantly produced by the lacrimal glands located under the upper eyelids, as well as by accessory glands located in the conjunctiva.

The tear accumulates at the inner corner of the eye and is then drained along the lacrimal canaliculi through the nasolacrimal duct into the oral cavity. The most important role in this process is played by the lower canaliculus, through which up to 90% of all tear fluid flows.

If the ducts become clogged for various reasons, then microorganisms begin to accumulate inside them. They cannot come out with tears, which leads to acute inflammation and suppuration - this is called dacryocystitis.

Symptoms of dacryocystitis in adults and children

Signs of dacryocystitis are quite noticeably expressed externally. A swelling forms at the inner corner of the eye, and profuse lacrimation begins. Patients complain of a feeling of fullness from the inside.

When pressing on the swollen area, purulent or mucous contents are released from the tubule, and moderate pain may be felt. With dacryocystitis, the eyelids turn red, swell, and the palpebral fissure narrows. After a few days, the swelling becomes softer and the skin turns yellow.

As a rule, this process develops only in one eye.

Acute inflammation of the lacrimal canal can lead to dire consequences if treatment is not promptly addressed. In practice, there are cases where the tumor reached the size of a walnut.

In such cases, there is a danger that pus will break into the tissues, and further into the depths of the skull - such conditions can be fatal.

Reasons why dacryocystitis may occur

This inflammatory disease occurs when the ducts are blocked or narrowed, which disrupts the normal flow of tear fluid. Here are the factors that can cause this condition.

1. Abnormal development or underdevelopment of the lacrimal ducts.
2. Stenosis is a congenital narrowing of the tear ducts.
3. Infectious diseases of the organs of vision.
4. Chronic runny nose.
5. Atherosclerosis, etc.

Dacryocystitis of newborns is a common occurrence in ophthalmological practice. This inflammatory disease is diagnosed in 10% of cases of all eye diseases. Let's take a closer look at the causes of dacryocystitis and methods of treating it in newborns.

Dacryocystitis of newborns

The main causes of eye inflammation in infants are congenital obstruction of the lacrimal canal, or an unruptured membrane in its lower section. What it is? Before a baby is born, its tear ducts have a thin membrane of fetal tissue.

After birth and the baby's first cry, it usually ruptures safely and the tear ducts open to allow fluid to pass through. It happens that this does not happen immediately, but within 10-14 days after birth. But if the membrane remains intact, the normal outflow of tears is disrupted and an inflammatory process develops.

Symptoms of dacryocystitis in infants are as follows:

• mucus or pus is released from the eyes;
• eyelids become swollen and red;
• eyelashes stick together after sleep.

Externally, the signs of dacryocystitis in newborns may resemble bacterial conjunctivitis.

However, this inflammatory disease is usually bilateral in nature, while dacryocystitis, with rare exceptions, develops on one side.

Eye treatment in children should begin as early as possible, otherwise there is a risk of phlegmon formation and serious damage not only to the organs of vision, but also to other parts of the head.

Dacryocystitis in newborns: treatment

Antibacterial therapy in such cases is carried out comprehensively. Eye rinsing, massage of the baby's lacrimal duct, treatment with antibacterial drops or ointments are prescribed, and if these measures do not help, a mechanical breakthrough of the membrane that closes the tear ducts is used, or their clearing.

Massage is an important procedure at the initial stage of treatment of dacryocystitis, as it is aimed at improving the patency of the lacrimal ducts.

How to properly massage the eyes of a newborn baby

The massage must be carried out in compliance with hygiene and safety requirements so as not to accidentally damage the child’s eyes or cause an infection. Be sure to cut long nails to avoid scratching your baby's skin. Before starting the procedure, wash your hands thoroughly and dry them.

It is better to start a massage after feeding, when the baby is in a calm, relaxed state. It is not recommended to do this if he is feeling anxious for any reason or has a fever.

First, you should rinse, clearing your eyes of traces of purulent discharge. Weak antiseptic solutions are suitable for this - for example, boric acid, furatsilin, chamomile, etc.

A cotton pad is moistened in the solution and traces of purulent fluid are carefully removed by moving from the outer corner of the eye to the inner. Use a separate disk each time.

Next, you should place your index finger on the point in the inner corner of the eye where the two canaliculi meet before entering the lacrimal sac. Ask your doctor to show you this place, and also feel it yourself to better understand where the desired point is.

Next, start moving your finger from top to bottom towards the baby’s nose, while applying gentle pressure. It is necessary to repeat such movements 6-10 times. If during the procedure pus is released from the lacrimal sac, it means that the eye massage is carried out correctly.

The contents of the ducts are removed using a cotton swab.

It is recommended to eliminate purulent discharge in this way 5-6 times a day. Upon completion of the procedure, you need to rinse the eye with antiseptic solutions, and then introduce antibacterial ointments or drops. This could be a solution of Levomycetin 0.25%, Vitabact or other medications.

As a rule, the doctor’s prescription looks like this:

• eye massage - 4-6 times a day, 6-10 repetitions;
• washing the lacrimal canals with an antiseptic solution;
• "Levomycetin" 0.25%, 1 drop 4-5 times a day.

Under no circumstances should you treat your child based on advice from online forums.

Incorrect therapy will lead to dacryocystitis taking an acute form, and it will be difficult to cope with it.

In general, in 80% of cases, the measures taken act favorably and the film breaks, ensuring normal patency of the tear duct. If this does not happen, surgical treatment is prescribed.

Probing and bougienage of the nasolacrimal duct

This method is used only after a course of antibacterial therapy coupled with eye massage, if the desired results have not been achieved. The procedure is performed in the clinic under local anesthesia.

A thin probe is inserted into the child directly into the nasolacrimal canal, the embryonic film is broken through, and then the canal is washed. It is necessary to restore patency by the age of six months, otherwise severe suppuration may develop in the future.

In addition, the thin membrane begins to thicken over time, and it becomes more difficult to break through.

After the operation, a course of eye massage and special drops are prescribed to prevent the formation of adhesions, which can lead to relapse of the disease and blockage of the nasolacrimal duct.

If the embryonic film breaks through on its own, and the fluid still stagnates in the ducts, they need to be expanded.

To do this, bougienage is prescribed; it is carried out using a tube that expands (stretches) the walls of the nasolacrimal canal.

It also happens that dacryocystitis constantly recurs after a seemingly complete cure. Then an additional diagnosis of the disease is carried out: perhaps the cause lies in an abnormal development of the lacrimal canal, a deviated nasal septum, or other factors.

Dacryocystitis in adults

Often this eye pathology occurs in middle-aged and elderly people, and women are diagnosed seven times more often than men. Unlike children, in whom the disease is usually congenital, in adults dacryocystitis occurs for a number of reasons:

• viral or bacterial eye pathologies that contribute to the development of edema that compresses the tear ducts;
• chronic inflammation of the tear ducts - dacryoadenitis;
• violation of the integrity of the tear ducts due to injuries;
• ingress of particles of cosmetic products due to untimely removal of makeup;
• polyps in the nasal cavity;
• consequences of severe bleeding - blood clots form and increased secretion of exudate begins, which can contribute to the formation of dacryolites.

Symptoms of dacryocystitis in adults and diagnosis

In general, the manifestations of the disease in both children and adults are similar. The area of ​​the lacrimal sac becomes noticeably red and swollen, and after some time purulent discharge begins from the eyes, as the nasolacrimal duct becomes clogged. When pressing on the inflamed area, a person experiences pain.

If the disease occurs in an acute form, the pain can be very sensitive. The tumor becomes denser, and after a few days it begins to soften and the swelling subsides. At this time, an abscess is formed, which can spontaneously open, and due to the outflow of pus from it, the swelling will decrease.

To diagnose dacryocystitis in adults, the doctor prescribes a general analysis of urine and blood, and a smear for bacterial culture. Rhinoscopy is required, which is necessary to exclude diseases associated with abnormalities in the structure of the nose.

If this does not happen, then this is a clear sign of blockage of the ducts.

Treatment of dacryocystitis

Therapeutic measures to treat the disease are generally similar to those prescribed for children. This is a massage of the tear ducts, the use of antibacterial drops and ointments. If these measures do not bring results, then mechanical cleaning of the canals using a special surgical probe or bougienage is prescribed.

Of course, other medications are used for adults. Drops can include Cefuroxime, Doxycycline, Chloramphenicol, and fusidic acid. If the formation of an abscess has already begun, physiotherapeutic procedures have a good effect.

In advanced cases of the disease, when standard methods do not help, surgical treatment is prescribed.

This may be dacryocystoplasty (opening the tear duct using a mini-balloon) or endoscopic dacryocystorhinostomy (creating a new tear duct).

An endoscope, a flexible tube with a mini-camera at the end, is inserted into the duct and an incision is made. Rehabilitation after surgery takes about a week, and there are no traces left after surgery.

Consequences of advanced dacryocystitis

A careless attitude towards this eye pathology, or the use of arbitrarily chosen folk methods of treatment can lead to negative consequences for eye health. Here are the complications that can result from advanced dacryocystitis:

• sepsis of tissues as a result of pus entering them;
• thrombosis of the cavernous sinus;
• thrombophlebitis of the veins of the orbital region;
• phlegmon of the orbit of the eye;
• inflammation of the membranes and tissues of the brain
• corneal ulcer, the appearance of a cataract.

The listed possible consequences are very serious, and even loss of vision in such cases is considered a favorable prognosis, since in most cases advanced dacryocystitis is fatal. Doctors warn that if you experience any discomfort, let alone externally noticeable inflammation in the eye area, you should immediately see a specialist who will make an accurate diagnosis and prescribe competent treatment.

MagazinLinz.ru team

Source: https://magazinlinz.ru/chto-takoe-dakriocistit.htm

Dacryocystitis - causes, symptoms and treatment

Dacryocystitis can be caused by narrowing and blockage of the nasolacrimal canal. If the permeability of the canal is impaired, then the exit of fluid is difficult, and this over time leads to an increase in the number of pathogenic microbes and the appearance of inflammation.

Dacryocystitis in newborns

Dacryocystitis in newborns is classified by specialists as a special category of eye diseases. The cause of the development of this condition is often intrauterine abnormalities. While the child is in the womb, the lumen of his nasolacrimal canal is filled with a mucous jelly-like mass, and the entrance itself is blocked by a membrane. When the moment of birth approaches, this barrier undergoes significant changes and breaks with the baby’s first full breath.

However, sometimes this membrane retains its integrity, on one or both sides, and this completely blocks the duct. Dacryocystitis in newborns looks like scanty purulent discharge, which is separated from the lacrimal capsule when you press on it.

By the age of three months, symptoms of excessive lacrimation appear. If the infectious inflammation is in an acute stage, then a month-old baby may develop phlegmon. Then characteristic swelling will appear, affecting the inner border of the lower eyelid and the lacrimal sac.

The disease is accompanied by fever, leukocytosis, and increased ESR levels. Over time, phlegmon can open both outward and inward, so infection of the orbit or cranial cavity occurs.

At this time, the disease becomes deadly for the infant.

The disease carries potential complications, since pus accumulating in the lacrimal sac is a danger to the cornea, because it can provoke the development of purulent ulcers.

Massage for dacryocystitis in newborns

In the early stages of the disease, with timely diagnosis, it is possible to cure dacryocystitis without surgery. Massage for dacryocystitis is a very important and effective remedy in terms of treatment, but it is effective only in young children due to the tenderness, elasticity and small size of the lacrimal sac and the lacrimal drainage system.

An important feature of massage is that it directly affects the cause of the disease: it eliminates the pathological accumulation of fluid in the cavity of the lacrimal sac.

Massage technique

The massage technique for dacryocystitis is quite simple. Just remember, before you start the massage, you need to very carefully cut off the nail, right to the root, right down to the skin. Remember that a child's skin is very delicate and can be easily injured.

So, we place the pad of our index finger on the inner corner of the eye, with the finger facing the bridge of the nose. Next, apply light pressure to this point.

It is important to measure the strength, to press and not too lightly, like stroking, but not with all your strength. The next stage is to continue pressing movements along the bridge of the nose.

Again, it is important to give this manipulation sufficient force. The essence of massage for dacryocystitis is that we apply pressure to the projection of the nasolacrimal duct, in which pus, mucus have accumulated and adhesions have formed.

It is important to remember that massage for dacryocystitis must be combined with the use of anti-inflammatory drops, which should be instilled after the massage, and in no case should this be done without proper consultation with an ophthalmologist.

Treatment

Today, conservative and surgical methods are used to treat dacryocystitis.

People often confuse the manifestations of dacryocystitis with the symptoms of conjunctivitis and try to self-medicate, which is not possible. At the first symptoms of dacryocystitis described above, you should immediately consult a doctor.

Most often, first, for this disease, antibacterial therapy is prescribed in combination with washing the nasolacrimal ducts and lacrimal sac using antibacterial (Ciprofloxacin, Levomycetin), anti-inflammatory (Dexamethasone) and vasoconstrictor drugs, as well as a special massage of the lacrimal sac, which promotes the outflow of accumulated fluid.

If dacryocystitis is in an advanced stage, only surgical intervention can achieve a positive effect.

This pathology involves the use of the following types of operations:

• bougienage and rinsing, the meaning of which is to restore the patency of the nasolacrimal duct;
• dacryocystorhinostomy, in which a new canal is formed between the lacrimal sac and the nasal cavity.

To prevent the occurrence of a purulent corneal ulcer, patients with inflammation of the lacrimal sac are prohibited from using contact lenses, applying blindfolds to the eyes, as well as performing any ophthalmological manipulations associated with touching the cornea.

The success of treating dacryocystitis, like any other disease, largely depends on the speed of establishing the correct diagnosis. Early detection of dacryocystitis increases the likelihood of successful treatment with irrigation, thereby reducing the likelihood of treatment with probing.

Symptoms of dacryocystitis

The lacrimal glands produce a liquid secretion that moisturizes and washes the surface of the eyeball, after which it flows towards the inner corner of the eye. In this area are the openings of the lacrimal canals, called lacrimal puncta. The canals connect to the lacrimal sacs, from where fluid can flow into the nasal cavity through the nasolacrimal duct.

If inflammatory changes appear in this structure, then, due to a violation of the patency of the canal, difficulties arise for the outflow of tear fluid. As a result, stagnation occurs in the lacrimal sac, which creates favorable conditions for the proliferation of bacterial microflora, which leads to the development of dacryocystitis.

The clinical picture of this pathology includes the following symptoms:

• lacrimation;
• purulent discharge from the nasolacrimal duct;
• redness and swelling of the conjunctiva, semilunar fold and lacrimal caruncle;
• narrowing of the palpebral fissure;
• swelling of the lacrimal sac;
• local pain when touched.

Diagnosis of dacryocystitis is carried out by an ophthalmologist based on examination and palpation of the affected area, the West nasolacrimal test, and radiography of the lacrimal canals.

Classification

There are several clinical forms of inflammation of the lacrimal sac:

• spicy;
• chronic;
• dacryocystitis of newborns.

Acute dacryocystitis in adults can be in the form of an abscess or phlegmon. The difference lies in the nature of the spread of inflammation - with an abscess, the inflammatory infiltrate is limited to the connective tissue capsule, and phlegmon has a diffuse nature of inflammation.

Depending on the etiology, the following forms of inflammation of the lacrimal sac can be distinguished:

• bacterial;
• viral;
• parasitic;
• traumatic.

Some authors separately identify dacryocystitis as chlamydial in nature, but it can also be attributed to the bacterial form of the disease.

Causes of dacryocystitis

Dacryocystitis is most common in young children. However, people over the age of 40 also have a high risk of developing dacryocystitis. In infancy, congenital abnormalities of the tear ducts are a common cause of dacryocystitis.

Causes of dacryocystitis in older children include:

1. Sinusitis;

2. Abscess of the nasal septum;

3. Tumors in the nasal passages;

4. Streptococcal and staphylococcal infections.

Symptoms of dacryocystitis

Dacryocystitis can be acute or chronic. Symptoms of dacryocystitis depend on the type of disease. People with acute dacryocystitis often experience more severe symptoms than those with chronic dacryocystitis.

Symptoms of acute dacryocystitis begin suddenly and often include fever and pus from the eyes. Bacterial infections are usually the cause of acute dacryocystitis.

Antibiotics can clear up the infection within a few days.

In chronic dacryocystitis, symptoms appear gradually and are less severe; fever and pus may not be present. However, some people may experience long-term pain or discomfort in the corners of the eye.

Chronic dacryocystitis can be caused by obstruction in the tear ducts. In some severe cases of chronic dacryocystitis, surgery is necessary to widen the tear ducts to relieve symptoms.

Acute or chronic dacryocystitis can cause the following symptoms:

1. Purulent discharge from the eyes;

2. Pain in the lower part of the outer corner of the eyelid;

3. Redness and swelling near the lower eyelid;

4. lacrimation;

5. Fever.

People with chronic dacryocystitis are less likely to experience pain, redness, or swelling.

Treatment of dacryocystitis

Doctors usually treat only acute dacryocystitis, when redness or pus is visible and is accompanied by fever. In all age groups, acute dacryocystitis resolves quickly after taking antibiotics.

To treat chronic dacryocystitis, doctors may prescribe steroid eye drops to reduce signs of inflammation.

People with dacryocystitis may benefit from hot compresses on the outside of the eye to open the ducts. Pain relievers and anti-inflammatory medications may help control pain and fever.

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Source: https://yaviju.com/bolezni/dakriotsistit-prichiny-simptomy-i-lechenie.html

Dacryocystitis: causes, symptoms, treatment

Dacryocystitis is an inflammatory or purulent-inflammatory lesion of the lacrimal sac. The tear duct, which carries secretions from the lacrimal sac to the mucous membrane of the eye, is quite thin. If for any reason there is an obstacle to the removal of secretions, stagnation occurs in the lacrimal gland.

Stenosis or blockage (full or partial) of the duct leads to the development of inflammatory processes. In places of stagnation, swelling, redness occurs and a favorable environment for the proliferation of pathogenic microorganisms is formed.

This disease is treated by an ophthalmologist; in some cases, the patient requires consultation with an ENT doctor.

Types of dacryocystitis

According to the severity of the process, dacryocystitis can be divided into 2 types:

• Acute dacryocystitis. It occurs when the lacrimal canaliculus is completely blocked and pathogens get inside; it can be accompanied by purulent processes and high fever.
• Chronic dacryocystitis. Occurs when the canal is partially or incompletely blocked, as well as when there is a pathology in the structure of the lacrimal ducts. It has more vague symptoms, often limited to swelling and discomfort without sharp pain. The chronic form, despite less severe pain, can be more dangerous than the acute form, since the likelihood of complications is high.

According to the mechanisms of occurrence, dacryocystitis is divided into the following types:

• viral – occurs as a result of pathogenic viruses entering the duct;
• bacterial - when there is stagnation in the lacrimal sac, it becomes vulnerable to bacteria;
• chlamydial (parasitic) – accumulations of chlamydia or other single-celled parasitic organisms can cause a blockage;
• traumatic - with a traumatic injury, the nasolacrimal duct may be damaged, or swelling after injury leads to pinching of it;
• allergic - swelling due to allergies can also compress the lacrimal canal;
• congenital - the newborn may have a clogged or insufficiently open lacrimal canal.

Women are more susceptible to the disease. This is due, firstly, to the smaller structure of the ducts. And secondly, when decorative cosmetics get into them, which causes blockage and allergic swelling.

Dacryocystitis in newborns

During intrauterine development in the fetus, the nasolacrimal duct is closed by a special membrane, which breaks through during childbirth or resolves itself shortly before birth. In some babies, the membrane remains on one or both sides after birth, leading to difficulty in tearing and inflammation of the lacrimal sac.

Causes of the disease

For newborns and infants, common factors in the development of the disease are:

• too narrow nasolacrimal duct;
• partial fusion of the nasolacrimal canal or preservation of the membrane in it;
• plugs that have not resolved after intrauterine development;
• complete overgrowth of the duct (extremely rare).

In adults, the most common causes of darkyocystitis are:

• diseases of the nasopharynx, such as sinusitis, sinusitis, nasal polyposis, allergic or catarrhal rhinitis;
• nasal injuries that lead to rupture of the canal or blockage due to pressure on it from traumatic edema;
• eyelid injuries leading to blockage of the secretion of the lacrimal glands;
• foreign bodies (sand, dust, cosmetic residues) getting into the duct;
• viral or bacterial infections can be both the cause of blockage and its consequence;
• infectious skin lesions around the eyes;
• hypothermia, leading to thickening of the tear secretion and blockage of the canal;
• prolonged exposure to high temperatures and dryness, which leads to drying out and blockage of the canal.

Constant exposure to certain risk factors can lead to chronic dacryocystitis. Possible influence of external factors, such as working in hazardous conditions. The structural features of the lacrimal ducts can also cause partial blockage and the occurrence of chronic dacryocystitis.

Risk group

Dacryocystitis is a fairly common disease that can occur in any person. However, for some groups of the population the risk is higher.

These include people:

• prone to allergic reactions, especially during “seasonal allergies”;
• with a chronic decrease in immunity, including in the autumn-winter period;
• patients with diabetes mellitus;
• having chronic nasal diseases or ophthalmological diseases;
• working in hazardous or dusty industries;
• women who abuse decorative cosmetics.

Symptoms of dacryocystitis

The acute purulent form of the disease is accompanied by the following symptoms:

• Swelling of the eyelid and around the eye, narrowing of the palpebral fissure. The eye looks half closed.
• An inflammatory swelling in the area of ​​the lacrimal sac, which can be very painful and hard.
• Pain in the eye area and its orbit.
• Fever, intoxication of the body.
• An abscess that usually opens to the outside with purulent contents leaking out.

In the acute form, the symptoms are expressed both visually and by sensations.

The chronic form of the disease has more vague symptoms:

• excessive tearing;
• swelling of the eyelid is not as pronounced as in the acute form;
• tumor of the lacrimal sac is present, but not so pronounced.

Despite its less painful course, the chronic form is even more dangerous due to its consequences for the eye. Chronic disruption of healthy tear production leads to inflammatory damage to the conjunctiva (the mucous membrane of the eye). The symptoms of chronic dacryocystitis may be similar to conjunctivitis. But dacryocystitis usually affects one eye, and conjunctivitis affects both.

In newborns, dacryocystitis manifests itself as:

• constant lacrimation;
• swelling of the eyelids;
• purulent discharge from the eyes instead of tears.

This is very dangerous for infants, as complications can arise both for the eyes and nasopharynx, and for the brain.

Complications

Ignoring symptoms and delaying treatment can lead to quite serious complications:

• an extensive abscess is formed, which can turn into phlegmon;
• the visual function of the eye is impaired as a result of drying out of the conjunctiva and purulent discharge from the tear ducts;
• purulent inflammatory processes in the eye threaten complications that are dangerous for the brain - up to meningitis and encephalitis;

Many people do not like to see doctors. But dacryocystitis is not a disease that will “resolve on its own.” Its consequences can be quite harmful; patients should be careful and conscientiously follow the recommendations of their doctor to avoid complications.

Diagnostics

For a specialized specialist (ophthalmologist), making a diagnosis is not a problem, since most of the signs are visible visually. But to clarify the diagnosis, determine the causes and select treatment, additional studies are carried out:

• the patency of the lacrimal ducts is determined - a dye is injected into the eye, which, if patency, enters the nasal cavity;
• probing the nasolacrimal duct to assess the extent of its damage;
• conducting eye biomicroscopy;
• instillation (fluorescein) test;
• Vesta color test;
• passive nasolacrimal test;
• microbiological examination - culture of secretions from the lacrimal canal;
• X-ray examination using special substances injected into the nasolacrimal canal;
• examination of the nose and sinuses;

The doctor may prescribe one or more additional research methods if necessary.

When diagnosing, it is important not only to establish the fact of the disease, but also to determine the causes and select the most effective treatment methods.

Treatment of dacryocystitis

To eliminate the disease and prevent complications, comprehensive treatment is carried out, which includes:

• ingestion of antibacterial and immunostimulating drugs;
• topical preparations, mainly in the form of ointments, emulsions;
• physiotherapeutic effects - UHF lamps, warming up;
• special massage, which is carried out up to 5-7 times a day, to open the lacrimal duct and remove the contents of the lacrimal sac;
• opening the abscess, washing and treating with antiseptic agents;
• formation of a new channel if necessary, if it itself has not recovered.

In the case of chronic dacryocystitis, it is possible to use a surgical method - widening the duct and forming the nasolacrimal duct. If the cause of the chronic form is deformation of the new cavity as a result of trauma, the help of a maxillofacial surgeon is required.

The following methods are used to treat newborns and infants:

• probing of the nasolacrimal duct - used if the prenatal membrane itself has not resolved;
• washing the eyes with special solutions;
• massage to squeeze out contents from the nasolacrimal ducts. Often, massage effectively removes the membrane that interferes with the outflow of tears;

If conservative methods do not help after three months of age, surgical intervention is possible to open the nasolacrimal duct.

In case of dacryocystitis, it is very important to exclude mechanical irritation of the eyeball. If the patient has vision problems and wears contact lenses, it is necessary to abandon them for the duration of treatment and use glasses. Contact lenses irritate the already damaged mucous membrane of the eye, which can lead to a purulent process on the conjunctiva and injury.

Prevention

In order to eliminate the possibility of dacryocystitis from your life, the following conditions should be observed:

• promptly and completely cure diseases of the nasal cavity and paranasal sinuses, such as sinusitis, rhinitis or nasal polyposis;
• avoid traumatic effects on the nasal area and eyes;
• in case of injury, consult a doctor to eliminate the consequences;
• avoid harmful conditions such as dusty environments or exposure to harmful substances;
• when working in hazardous conditions (construction, chemical production), use protective equipment - special glasses and respirators;
• avoid extreme temperatures (hypothermia or dry heat) for long periods of time;

In order to avoid the development of the disease, if you notice one or more symptoms, you should definitely consult a doctor.

Source: https://www.polyclin.ru/articles/dakriocystit/

Dacryocystitis - treatment of tear ducts in adults, if they are clogged, how to treat glands and tubules, chronic inflammation of the sac where it is located

When the nasolacrimal duct is blocked or narrowed, adults can develop a dangerous eye disease - dacryocystitis.

Without proper diagnosis and quality treatment, this disease is fraught with irreversible consequences, which in advanced cases can even lead to the death of the patient.

Therefore, in this article we will consider all aspects of this disease, symptoms and modern treatment methods.

What it is?

Dacryocystitis is an infectious and inflammatory disease characterized by damage to the lacrimal sac of the eye. Typically, this disease is most often observed in people aged 30-60 years. In women, this disease occurs more often due to the narrower anatomical structure of the nasolacrimal ducts.

As a rule, in adults, the lesion with dacryocystitis is always one-sided.

The disease occurs due to blockage of the nasolacrimal canal. As a result, tear fluid accumulates in the lacrimal sac and cannot penetrate outside. Due to the disruption of the outflow of tear fluid, active proliferation of microorganisms occurs, which leads to inflammation and the formation of mucopurulent discharge.

Manifestation of dacryocystitis in adults

about effective methods of combating eye redness in the material.

Causes

In adults, dacryocystitis occurs due to narrowing and closure of the nasolacrimal duct. Due to the narrowing of the channels, fluid circulation is disrupted. As a result of this, stagnation of the tear secretion occurs, in which microorganisms begin to actively develop.

Swelling of the tissues surrounding the nasolacrimal duct occurs as a result of inflammatory diseases of viral or bacterial origin (respiratory infections, chronic rhinitis, sinusitis).

The disease can also be caused by:

• fractures of the bones of the nose and orbit;
• damage and disruption of the integrity of the lacrimal canaliculi;
• nasal polyps;
• penetration of debris, dust and other foreign bodies into the eye.

Also, the following factors may contribute to the occurrence of the disease:

• metabolic disease;
• diabetes;
• weakening of the immune system;
• allergic reactions;
• interaction with chemicals hazardous to the organs of vision;
• sudden temperature fluctuations.

Symptoms

The following clinical manifestations occur with dacryocystitis:

• constant lacrimation;
• mucopurulent discharge from the eyes (mucopurulent conjunctivitis);
• hyperemia and swelling of the lacrimal caruncle, conjunctiva and semilunar fold;
• swelling of the lacrimal sac;
• sore eyes;
• narrowing of the palpebral fissure;
• increased body temperature;
• general intoxication of the body.

Dacryocystitis can have an acute or chronic form of the disease. Clinical manifestations of the forms of the disease vary.

In the acute form of the disease, clinical symptoms manifest themselves most clearly. In the area of ​​inflammation of the lacrimal sacs, sharp redness of the skin and painful swelling occur. Due to swelling of the eyelid, the palpebral fissures become very narrow or completely closed . The patient may experience pain in the eye area, chills, fever, and headache.

Advanced stage of dacryocystitis

The chronic form of the disease is characterized by constant lacrimation and swelling in the area of ​​the lacrimal sac. When pressing on this area, mucopurulent exudate is released from the lacrimal canals. A swollen neoplasm forms in the area of ​​the lacrimal sac, visually resembling a bean . As it develops, it becomes densely elastic.

Inside the cavity of this neoplasm, pus accumulates, which, when pressed, is released out. With further development of the infection, phlegmon of the orbit or fistulas may occur.

Read more about the symptoms of conjunctivitis here.

Diagnostics

In order to identify the disease, the patient must be examined by an ophthalmologist.

As a rule, dacryocystitis is quite easily diagnosed due to its characteristic clinical symptoms.

During the examination, the doctor conducts an external examination and palpation of the area of ​​the lacrimal sac, performs the West lacrimal-nasal test, instillation fluorescein test, and radiography of the lacrimal ducts.

The most commonly performed test is the West nasolacrimal test. It is one of the most common diagnostic techniques. During this procedure, a solution of collargol or protargol is instilled into the conjunctival sac.

These staining substances are used to determine the patency of the lacrimal canal. A cotton wool or turundum swab is inserted into the sinus. Traces of the coloring substance should appear on the tampon no later than after 5 minutes.

A delay in the entry of the substance into the nasal cavity or its absence indicates a violation of the patency of the nasolacrimal duct.

Read more about perimetry in the article.

The degree of patency of the entire lacrimal drainage system, as well as the level and localization of areas of obliteration, are determined using contrast radiography. During this diagnostic method, iodolipol solution is used.

If it is necessary to identify microbial pathogens of dacryocystitis, bacteriological culture is performed.

To clarify the diagnosis, the patient must additionally undergo examination by an otolaryngologist . As a rule, an otolaryngologist performs rhinoscopy for dacryocystitis. The patient may also need to consult a dentist, traumatologist, neurologist or neurosurgeon.

Treatment

As a rule, if dacryocystitis is without complications, the prognosis for recovery is favorable. Treatment of dacryocystitis, first of all, depends on the form of the disease and the causes of its occurrence.

The treatment process for dacryocystitis is generally divided into two parts:

• restoration of patency of the nasolacrimal canal;
• anti-inflammatory therapy.

When treating dacryocystitis in adults, bougienage and rinsing of the nasolacrimal duct with disinfectant solutions and the use of antibacterial eye drops and ointments are performed.

Bougienage is the most common, gentle method of restoring the patency of the nasolacrimal canal. During this procedure, the blockage of the nasolacrimal canal is physically removed using a special rigid probe (bougie).

Initially, patients suffering from dacryocystitis are prescribed enhanced antibacterial treatment to avoid infectious complications. This is necessary because with dacryocystitis there is a possibility of a purulent form of encephalitis or a brain abscess.

Dacryocystitis in old age

If an abscess of the lacrimal sac has formed, it is opened through the skin. Before opening the abscess, systemic vitamin therapy and UHF therapy are performed.

After opening, the wound is drained and washed with antiseptic solutions of furatsilin, dioxidin, and hydrogen peroxide.

To prevent further development of infection, antibacterial drops (chloramphenicol, miramistin, sodium sulfacyl, gentamicin drops) and antibacterial ointments (erythromycin, tetracycline eye ointment, floxal) are instilled into the conjunctival cavity.

In addition to local treatment, systemic antibacterial therapy with broad-spectrum drugs is carried out. For this purpose, cephalosporins, aminoglycosides, and penicillins are used.

In advanced forms of dacryocystitis, when standard drug treatment is ineffective, dacryocystoplasty or endoscopic dacryocystorhinostomy is performed.

Endoscopic dacryocystorhinostomy

Endoscopic dacryocystorhinostomy is a surgical procedure used to treat dacryocystitis in adults. Special modern minimally invasive equipment is used to perform the operation. Dacryocystorhinostomy can only be performed on patients who do not have an allergic reaction to anesthetic drugs.

During the operation, a special flexible tube is inserted into the tear duct - an endoscope with a microscopic camera. An endoscope is used to make an incision in the blocked tear duct. The rehabilitation period after surgery is 6-8 days. To avoid inflammation of the cornea, he prescribes a course of antibiotics.

The advantage of this operation is that it does not leave visible skin scars on the face or damage to the tear ducts.

about treating astigmatism at home by following the link.

Balloon dacryocytoplasty

In most cases, balloon dacryocystoplasty is used. This is a safe operation that can be performed even on children over 1 year old.

During the operation, a special thin conductor is inserted into the nasolacrimal canal through the corner of the eye, which is equipped with a microscopic expanding balloon filled with liquid.

In a blocked area of ​​the nasolacrimal canal, the balloon expands and opens the duct using pressure and is then removed from the canal. The procedure is performed under local anesthesia. After the operation, a course of antibiotics and eye drops are prescribed to prevent the development of infection.

Read more about Betoptik eye drops here.

Complications

Dacryocystitis is a rather dangerous disease, since if left untreated it can cause various complications.

The chronic form of the disease is especially dangerous. In this case, infection of other membranes of the eye is possible. There is a possibility of developing concomitant diseases - blepharitis, conjunctivitis, keratitis.

With the further development of chronic dacryocystitis, the cornea is affected and a purulent ulcer is formed.

Further development of the ulcer can also lead to endophthalmitis, which is characterized by inflammation of the internal structures of the eye.

A significant complication can be the development of life-threatening diseases that can lead to disability or death in the patient:

• sepsis;
• orbital phlegmon;
• thrombophlebitis of the orbital veins;
• thrombosis of the cavernous sinus;
• inflammation of the meninges and brain tissue.

Prevention

To prevent dacryocystitis, it is necessary to promptly treat inflammatory diseases of the eyes and ENT organs, as well as avoid eye damage and foreign bodies. With timely diagnosis and treatment of dacryocystitis, complete recovery is possible without serious consequences.

Farsightedness: how to restore vision.

Read this article about why discomfort occurs when wearing lenses.

Do glasses with holes help restore vision: https://eyesdocs.ru/ochki/kompyuternye/s-dyrochkami-perforacionnye.html

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conclusions

Dacryocystitis is a dangerous eye disease in adults that can lead to serious complications. A similar disease is temporal arteritis, which is fraught with great consequences if misdiagnosed and untimely treatment at the clinic.

Therefore, it is necessary to carry out correct, timely treatment and, of course, preventive measures to avoid the occurrence of this disease. There are various techniques to prevent the disease, such as massage, eye exercises to improve vision, yoga.

Source: https://EyesDocs.ru/zabolevaniya/dakriocistit/u-vzroslyx-lechenie.html

Dacryocystitis - symptoms, treatment of chronic dacryocystitis in adults

Dacryocystitis is an inflammatory disease of the lacrimal sac, which occurs due to blockage (obliteration) or narrowing of the nasolacrimal duct. This pathology accounts for about 5% of all diseases associated with impaired lacrimal drainage.

Women are more often affected - this disease occurs 7 times more often in them than in men. This is due to the anatomical features of the lacrimal canals. People over 30 years of age are more often affected, but at the same time, there is a separate form of the disease - congenital dacryocystitis.

Inflammation of the lacrimal sac is dangerous for the patient in that it can cause the development of suppuration of the subcutaneous fatty tissue of the eyelids, nose, cheeks and other areas of the face.

Dacryocystitis can also be complicated by inflammatory diseases of the brain, such as encephalitis, brain abscess or meningitis.

Symptoms of dacryocystitis

The lacrimal glands produce a liquid secretion that moisturizes and washes the surface of the eyeball, after which it flows towards the inner corner of the eye. In this area are the openings of the lacrimal canals, called lacrimal puncta. The canals connect to the lacrimal sacs, from where fluid can flow into the nasal cavity through the nasolacrimal duct.

If inflammatory changes appear in this structure, then, due to a violation of the patency of the canal, difficulties arise for the outflow of tear fluid. As a result, stagnation occurs in the lacrimal sac, which creates favorable conditions for the proliferation of bacterial microflora, which leads to the development of dacryocystitis.

The clinical picture of this pathology includes the following symptoms:

• lacrimation;
• purulent discharge from the nasolacrimal duct;
• redness and swelling of the conjunctiva, semilunar fold and lacrimal caruncle;
• narrowing of the palpebral fissure;
• swelling of the lacrimal sac;
• local pain when touched.

Diagnosis of dacryocystitis is carried out by an ophthalmologist based on examination and palpation of the affected area, the West nasolacrimal test, and radiography of the lacrimal canals.

Causes of dacryocystitis

The main role in the pathogenesis of the disease is played by disruption of the nasolacrimal duct. In the congenital variant of the pathology, this is associated with anomalies in the development of the nasolacrimal duct (true atresia), the presence of a gelatinous plug or epithelial membrane in it.

Most often, dacryocystitis develops in diseases such as acute respiratory viral infections, sinusitis or rhinitis, skull fractures, nasopharyngeal polyps, eye injuries when the lacrimal openings are damaged. In these cases, soft tissue swelling often occurs, which leads to stenosis of the nasolacrimal duct.

Due to the disruption of the outflow of tear fluid, its ability to suppress bacterial growth is reduced.

Moreover, substances contained in the secretion of the lacrimal glands can become the basis for the proliferation of pathogenic bacteria.

Most often, inflammation is caused by microorganisms such as staphylococci, streptococci, chlamydia, pneumococci or the causative agent of tuberculosis. In some cases, a viral infection may develop.

As secretion accumulates in the lacrimal sac, its walls stretch and microscopic damage to the epithelium occurs along its entire length.

As a result, microflora can easily penetrate the wall of the lacrimal sac and cause inflammation.

Certain groups of people have an increased risk of developing dacryocystitis. This includes people with diabetes, immunodeficiency, and regularly exposed to various harmful factors at work.

Classification

There are several clinical forms of inflammation of the lacrimal sac:

• spicy;
• chronic;
• dacryocystitis of newborns.

Acute dacryocystitis in adults can be in the form of an abscess or phlegmon. The difference lies in the nature of the spread of inflammation - with an abscess, the inflammatory infiltrate is limited to the connective tissue capsule, and phlegmon has a diffuse nature of inflammation.

Depending on the etiology, the following forms of inflammation of the lacrimal sac can be distinguished:

• bacterial;
• viral;
• parasitic;
• traumatic.

Some authors separately identify dacryocystitis as chlamydial in nature, but it can also be attributed to the bacterial form of the disease.

Treatment of dacryocystitis in adults

Therapy for this disease should be carried out only in a medical institution, since independent treatment is not only not effective enough, but also increases the risk of developing complications, which were mentioned above.

Therapeutic measures begin with vitamin and physiotherapy, the purpose of which is to reduce the density of the infiltrate. For this purpose, UHF and dry heat are used.

In the abscess form of acute dacryocystitis, the abscess is opened after the appearance of fluctuations.

Next, antibacterial therapy is started, which consists of washing the abscess cavity or lacrimal sac with antiseptic solutions (hydrogen peroxide, furatsilin, dioxidine, etc.).

Eye drops or ointments containing an antibiotic, for example, gentamicin, chloramphenicol, erythromycin, tetracycline, etc., are also used locally.

At the same time, broad-spectrum antibacterial agents belonging to the group of cephalosporins, penicillins, and aminoglycosides are administered parenterally. Only after the inflammation has subsided is dacrystorhinostomy performed - an operation to create an opening. Through which the lacrimal sac and the nasal cavity will communicate.

In newborns, treatment includes several stages, such as massage of the lacrimal sac, rinsing the canal and probing it both retrogradely and through the lacrimal openings. This set of measures must be carried out gradually over a period of approximately 10-12 weeks. If these measures are ineffective, then an operation is performed to create an opening between the lacrimal sac and the nasal cavity.

Chronic dacryocystitis, as well as acute, is treated surgically to create a path for the outflow of tear fluid. Modern ophthalmic surgery has minimally invasive methods for treating this disease, based on the use of laser or endoscopic techniques.

This treatment method will allow you to restore the patency of the lacrimal ducts without damaging surrounding tissues.

The prognosis for recovery in the absence of complications of dacryocystitis is usually favorable.

Lack of timely treatment leads to the development of pathologies such as orbital phlegmon, thrombophlebitis, cavernous sinus thrombosis, inflammatory diseases of the brain and its membranes.

In severe cases, the infectious process can become generalized, leading to the development of a condition such as sepsis, which often leads to the death of the patient.

When an infection of other localizations occurs, the prescription of antibiotics is required, which are administered parenterally. It is possible to attract specialists of the relevant profile.

Prevention

Since the cause of dacryocystitis is untreated inflammatory diseases of the ENT organs, the prevention of this pathology should consist of timely diagnosis and treatment of diseases such as sinusitis, rhinitis, ARVI and nasal polyps.

An important role is also played by avoiding injuries to the eyes and bones that form the facial part of the skull. If you do get injured, you need to take action as soon as possible - consult a doctor without self-medicating.

If a newborn has signs of abnormal development of the nasolacrimal duct, then it is recommended that he regularly undergo massage to improve the outflow of tear fluid. Correction of developmental disorders should be carried out as early as possible, before serious complications arise.

Treatment of dacryocystitis in St. Petersburg

Inflammation of the lacrimal sac is a dangerous pathology that is best left to qualified specialists. This way you can avoid the development of severe complications and achieve recovery as soon as possible.

The Ocodent Medical Center has all the necessary means to treat dacryocystitis of any complexity.

With us you can undergo all the necessary diagnostic procedures, based on the results of which our doctors will be able to make a diagnosis and prescribe the required therapy.

You can always ask for help or sign up for a consultation with highly qualified doctors - specialists at our medical center.

Source: https://okodent.ru/info/articles/dakriotsistit-simptomy-lechenie-khronicheskogo-dakriotsistita-u-vzroslykh/