Blocked tear ducts. Causes and symptoms of inflammation of the tear duct. Treatment methods for tear duct inflammation

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 a nasal tear 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 eye doctor examines your eyes regularly and also identifies problems that arise between regular examinations and helps you choose best practices treatment.

Lacrimal duct lavage is an ophthalmological procedure, the essence of which is to inject into the nasolacrimal duct special liquid with moderate pressure. Used for therapeutic and diagnostic purposes. Can be performed at any age, in infants and adults.

The procedure is performed under anesthesia with special eye drops. Rinsing the tear duct in newborns helps remove a blockage that is blocking drainage. intraocular fluid. This blockage occurs quite often in the first two months of a baby’s life.

Canal blockage in adults occurs due to complications of inflammatory processes or tumors of various nature. Also, rinsing is necessary after eye injuries.

Flushing the canal for diagnostic purposes is prescribed if children or adults experience excessive tearing. And also with a high concentration of intraocular fluid. For therapy, the event is used for the following pathologies:

• Dacryocystitis in infants. In the event that massage does not help the child;
• Inflammatory process or stenosis in the canals;
• Partial obstruction of the canal.

The procedure cannot be performed if there are purulent or watery formations in the lacrimal sac. If this is not taken into account, dire consequences may follow.

Probing the lacrimal ducts

Probing is used for diagnosis and therapy. Thanks to this event, the place where the traffic jam has formed is determined. For the procedure, a special probe is used, which is carefully and smoothly inserted into the lacrimal duct. The operation does not last long. Used as pain relief eye drops.

The procedure is usually prescribed for young children. If you use this event regarding adults in therapeutic purposes, it will not bring the desired result.

Preparation and technique

Before the procedure, anesthetic drops are injected into the conjunctiva. If the event is performed for therapeutic purposes, painkillers may not be used. The tear duct irrigation kit is sterile. The kits are disposable.

The manipulation is performed in a sitting position, with the body slightly tilted forward. The specialist fills the syringe with the solution and places a blunt needle on it to rinse the tear duct. The eyelid is pulled down, a syringe is placed in the canal and the solution is injected into the eye.

Actions after washing

Rinsing the nasal canals is a kind of micro-operation. Without anesthesia it is quite unpleasant. To consolidate the results obtained and to eliminate the risk of complications, it is necessary to take the following measures:

• Massage throughout the week tear ducts;
• Bury in eyeball antibacterial drops prescribed by the treating specialist.

Most often, after washing the lacrimal ducts, the desired effect is observed immediately. If the patient’s condition does not improve within a month, the event must be repeated.

At birth defects or a curvature of the bridge of the nose as a result of injury, there is no point in performing this measure to remove the plug. More severe surgical interventions are required.

Complications

Like any surgical procedure on the eyes, rinsing the tear ducts can cause complications. Each body reacts individually to anesthesia and surgical intervention.

Most often, small scars may form at the injection site of the syringe. This may cause the blockage to re-form. The washing will have to be repeated. To avoid unpleasant consequences, follow all instructions and recommendations of the treating specialist.

Alternative names: diagnostic lavage of the lacrimal ducts, probing and lavage of the lacrimal ducts.

Rinsing the lacrimal canaliculi is a diagnostic procedure in ophthalmology that involves injecting liquid into the lacrimal canaliculi under moderate pressure. This test is used to check the patency of the lacrimal ducts. The manipulation can also be of a therapeutic nature - in this case, various substances: antibiotics for destruction pathogenic flora, antiseptics (furacilin, boric acid) to prevent infection, glucocorticoids and proteolytic enzymes to improve tubular patency.

Most often, lavage is combined with probing of the lacrimal ducts - the combination of these two techniques allows you to achieve better results in treatment various diseases tear-producing and lacrimal drainage systems.

Only an ophthalmologist with special skills has the right to perform this procedure. If you attempt to perform the procedure on your own, damage to the eye or periocular structures may occur.

Preparing for washing

A few drops are instilled into the conjunctival cavity local anesthetic. When performing lavage as a therapeutic procedure, you can do without an anesthetic. Washing is carried out with a solution of furatsilin 0.02% or isotonic solution sodium chloride using a metal cannula and a 5 ml syringe.

How to wash the tear ducts

The patient sits on a chair or couch, bending slightly. The doctor carefully inserts a metal cannula attached to a syringe with washing liquid through the lacrimal opening into the canaliculus. The cannula is inserted to the maximum possible length, after which it is pulled back 1-2 mm so that it does not rest against the canal wall. The eyelid of the corresponding eye is pulled outward. Next, gently press the syringe plunger and evaluate the dynamics and ease of fluid passage. The same procedure is carried out with the other eye.

When performing therapeutic rinsing, special solutions are used. The procedure itself is carried out similarly to the diagnostic one.

Interpretation of results

With normal patency of the canals, even by lightly pressing the syringe plunger, liquid flows freely from the nose.

When fluid leaks from the opening of the same lacrimal canal into which the cannula was inserted, stenosis is diagnosed internal department channel.

If fluid instantly flows out from the opposite lacrimal punctum, this indicates stenosis (fusion) of the mouths of the lacrimal canals or stenosis of the nasolacrimal duct.

If fluid begins to flow from the opposite lacrimal punctum after a few seconds, or when the pressure on the syringe plunger increases, this indicates stenosis of the nasolacrimal duct. In this case, there may be an admixture of blood or pus in the washing liquid.

If fluid appears from the nose with a significant increase in pressure on the syringe piston, we can talk about incomplete closure (stenosis) of the nasolacrimal duct.

Indications

Rinse the tear ducts with diagnostic purpose carried out when the patient complains of lacrimation or lacrimation.

For therapeutic purposes, washing is carried out for the following diseases:

If there is a blockage or narrowing nasolacrimal duct adults may develop dangerous disease eye – dacryocystitis. Without correct diagnosis And quality treatment this disease is fraught 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 methods treatment.

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 manifests itself more often due to a narrower anatomical structure 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 disruption of the outflow of tear fluid, active proliferation of microorganisms, which leads to inflammation and the formation of mucopurulent discharge.

Manifestation of dacryocystitis in adults

Read also about effective methods combat redness of the eyes.

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, it happens stagnation of tear secretion, in which microorganisms begin to actively develop.

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

The disease also may cause:

• 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, occurrence of the disease The following factors may contribute:

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

Symptoms

With dacryocystitis the following occur: clinical manifestations:

Swelling of the lacrimal caruncle

• constant ;
• mucopurulent discharge from the eyes ();
• 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 may be acute or chronic form diseases. Clinical manifestations forms of the disease vary.

At acute form Disease clinical symptoms manifest themselves most clearly. In the area there is sharp redness skin and painful swelling. 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 reminiscent of beans . 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.

Diagnostics

In order to identify the disease, the patient must undergo examination 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.

First of all, the ophthalmologist listens to the patient’s complaints and carries out an external examination of the lacrimal sac area. When palpating this area, purulent secretion should be released from the lacrimal canaliculi.

The most commonly performed test is the West nasolacrimal test. It is one of the most common diagnostic techniques. During this procedure in conjunctival sac instill a solution of collargol or protargol. 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. Delay in the entry of the substance into nasal cavity or its absence indicates violation of the patency of the nasolacrimal duct.

Read more about the perimeter in.

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 a solution of iodolipol is used.

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

To clarify the diagnosis, the patient needs 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.

Treatment process Dacryocystitis is generally divided into two parts:

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

In the treatment of dacryocystitis in adults, bougienage and lavage of the nasolacrimal canal are performed. disinfectant solutions, application and ointments.

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 purulent form encephalitis or brain abscess.

Dacryocystitis in old age

The acute form of the disease is treated in a hospital setting. As a rule, in this case it is prescribed intramuscular injections benzylpenicillin sodium salt(3-4 times a day) or oral administration of tetracycline (4 times a day), sulfadimezine (4 times a day).

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 antiseptic solutions furatsilin, dioxidin, hydrogen peroxide. To prevent further development infections, antibacterial drops (miramistin, sulfacyl sodium) and antibacterial ointments (erythromycin, floxal) are instilled into the conjunctival cavity.

Except local treatment carry out systemic antibacterial therapy with drugs wide range actions. For this purpose, cephalosporins, aminoglycosides, and penicillins are used.

In advanced forms of dacryocystitis, when the standard drug treatment ineffective, carried out dacryocystoplasty or endoscopic dacryocystorhinostomy.

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 have absent allergic reaction for 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. Rehabilitation period after surgery – 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.

When tear ducts are blocked, the normal, natural flow of tear fluid is disrupted. Because of this, the eyes water all the time, increasing the risk of developing an infection. Obstruction of the lacrimal duct is diagnosed in approximately 20% of newborn babies.

However, most often, during the first few months of a child’s life, the tear ducts are cleared and their normal patency is restored. The main thing is to carefully monitor hygiene and regularly massage the lacrimal canal. This will help prevent inflammation. Well, if you still need the help of a doctor, the treatment will be quick and painless.

In adults, blockage of the tear duct may also be diagnosed. This condition is most often caused by an infection. Blockage may occur due to inflammatory process, injury, or tumor. Treatment always depends on the age of the patient, as well as the specific cause of the blockage.

About how treatment is carried out for children and adults, how the tear duct is cleaned, probing, massage, rinsing, how is it carried out? We'll talk about this with you today:

Massage of the tear duct in children

As we have already said, most newborns with congenital obstruction lacrimal canal, the canal clears itself in the first months of life. If cleansing does not occur, the doctor will prescribe a special massage:

Gently squeeze the fluid out of your baby's tear sac. Make sure that purulent contents do not get into your nose or ears. Then drip a warm solution of furatsilin into your eyes (1 tablet per half liter boiled water). Moisten a cotton swab or pad with the solution, rinse, and remove the purulent discharge.

Now gently apply several vibrating or jerky pressures with your finger on the area of ​​the lacrimal sac. Carry out such movements from top to bottom, as well as from internal corner the top of the eye to the bottom. The purpose of this massage is to break through the gelatinous embryonic film of the tear duct.

At the end of the massage, disinfect your eyes by dropping 0.25% chloramphenicol eye drops. You can use the drug Vitabact.

Massage must be carried out 5 times a day, for two weeks. If everything is done correctly, the film that stops the canal will break through in 3-4 months. Your pediatrician will show you how to do a massage correctly. He will give everything necessary recommendations by application medicines(eye drops).

Probing, rinsing

If the massage does not bring the desired result, the doctor will clear the tear duct using probing. Usually this operation is performed on babies 2-3 months old. The procedure is relatively simple, it is carried out in the eye clinic of the clinic, under local anesthesia. During the procedure, the doctor

Using the inserted Sichel probe, the lacrimal canal is expanded. Then, using another, longer Bowman probe, the doctor makes a breakthrough - pierces the interfering film. The entire manipulation takes no more than 5-10 minutes.

After successful probing, mandatory rinsing channel using disinfectant solutions. To prevent infection, you will need to use antibiotic eye drops after the procedure. Necessary drug Your doctor will prescribe it for you.

In addition, for about another 1-2 weeks after probing, you need to continue the course of massage in order to prevent relapse, as well as to prevent the development of adhesive process.

It should be borne in mind that the surgical process becomes more complicated with age. Therefore, if a baby has a blocked tear duct, treatment should be carried out as early as possible.

Probing the tear duct in adults

Unfortunately, massage or probing of the lacrimal canal will not help a teenager or an adult. Canal obstruction can be removed by copious rinsing with disinfectant solutions. If rinsing does not help, the lacrimal canal still secretes purulent contents, endoscopy is performed.

Most often, adults require surgical treatment. Before this, the patient is prescribed a course of antibacterial therapy. This is necessary to exclude possible complications after the operation.

After surgical excision of the interfering film, in postoperative period, the patient must continue to use medicines. Most likely, the doctor will prescribe a special spray to relieve swelling of the nasal mucosa. You also need to use eye drops. These drugs are necessary to prevent the development infectious process, as well as to reduce postoperative inflammation. Be healthy!