A fairly common disease in newborns is dacryocystitis, which is caused by obstruction of the lacrimal canal. This disease, according to statistics, is observed in 2-5% of infants. The causes and tactics of treating dacryocystitis are well understood. Often performed probing of the lacrimal canal in the diagnosis and treatment of the disease.
Causes of the disease
To understand the cause of the disease, you need to remember the anatomy of the eye. The structure of the eye is quite complex. For the functioning of this system, tear fluid plays an important role. A tear forms in the lacrimal gland, serves to moisturize the conjunctiva and cornea of the eye. The tear fluid from the eye is discharged along the tear ducts. These include a pair of lacrimal openings, a pair of lacrimal tubules, a lacrimal sac and a lacrimal-nasal canal. Lacrimal fluid flows through the channel into the lower part of the nasal conch, where it evaporates. Dacryocystitis occurs in cases where the connective tissue membrane does not atrophy even before the birth of the baby. This membrane does not allow amniotic fluid to enter the lacrimal canal. If it does not erupt after the first breath or cry of the child, then stagnation occurs and lacrimation is impaired. Therefore, the cause of dacryocystitis is a violation of lacrimation, as well as the attachment of a secondary infection.
Clinic of Dacryocystitis
Indisputable early signs of dacryocystitis in a baby are swelling of the inner corner of the eye, separation of the mucopurulent contents, the presence of lacrimation and, less commonly, lacrimation. Conjunctival redness is sometimes noted. But the main thing, in the clinic of this disease, is an increase in the amount of purulent secretion from the lacrimal openings with pressure on the projection of the lacrimal sac.
To confirm the diagnosis, it is recommended to conduct a collargol test ( West test ). It is necessary to instill in the eyes 1 drop of a 3% solution of collargol. Insert a cotton wick into the nasal passage. If after five minutes traces of paint are visible on the wick, then a positive test is recorded. A positive test can also be said in the case when conjunctival enlightenment occurs within three minutes after instillation of collargol. The child does not suffer from dacryocystitis, it is necessary to differentiate his condition with other diseases. An increase in the time of staining the wick to 20 minutes indicates a delayed sample, more than 20 minutes indicates a negative sample. If the nasal test is negative, then this fact confirms the diagnosis of dacryocystitis.
The chronic course of dacryocystitis is characterized by a profuse purulent secretion, especially after a child's sleep.
After diagnosis, treatment should be started immediately, since dacryocystitis is dangerous with complications - phlegmon of the lacrimal sac, the development of fistulas. Probably, probing of the lacrimal canal will be required.
Disease treatment
Treatment begins with a massage. Massage the child with clean hands. The index finger makes jerky movements from the inner edge of the palpebral fissure (projection of the lacrimal opening) along the lacrimal-nasal canal to the wings of the nose. The finger, as it were, wants to break the embryonic film under the influence of increased pressure in the channel.
- Squeeze out the contents of the lacrimal sac, remove it with a sterile cotton swab.
- To instill a solution of furatsillina 1: 5000 in the eyes.
- Massage the area of the lacrimal sac with jerky movements up to 10 times from top to bottom.
- Bury a drop of chloramphenicol 0.25% solution or vitabact
- Massage 5-6 times a day.
If the massage within two to three weeks does not give a result, the membrane does not break through, and stagnation persists, then it is necessary to decide on the probing of the lacrimal canal. This medical intervention is performed in the ophthalmologist’s office, preferably at the age of two to three months. Probing of the lacrimal canals in infants should be done only by an experienced specialist.
Probing of the lacrimal canal is carried out under local anesthesia, the child is swaddled tight. With the help of Siegel's conical probes, starting with a smaller size, lacrimal openings and tubules pass. Next, a Bowman probe breaks through the membrane in the lacrimal-nasal canal. After sounding of the eye is made, the canal is washed with a disinfectant solution.
At home, parents should continue to massage to prevent relapse, instill disinfectant and vitamin drops (phloxal 1 drop 1 time per day for 7 days) and periodically show the baby to a specialist. Usually re-sounding of the lacrimal canal is not required.
Dacryocystitis is a disease of the newborn, the treatment of which is necessary. Timely treatment leads to a complete recovery of the child.