Very often, in the first days of a newborn's life , purulent discharge from the eyes is observed. The cause of such discharge may be a disease such as dacryocystitis in newborns. It must be differentiated with mild inflammation of the mucous membrane of the eye, in which white discharge from the eyes is observed. This disease is an inflammatory process that occurs in the lacrimal sac.
During the prenatal period of the child in the nasal ducts there is a gelatinous film or cork that protects it from the penetration of amniotic fluid. During birth, during the first breath and cry of the newborn, this film breaks, resulting in patency of this channel. If this does not happen, the tear can stagnate in the lacrimal sac, against this background, the infection joins, after which an acute or chronic form of dacryocystitis develops.
The first signs of this disease are purulent discharge from the eye, lacrimation, lacrimation is rarely combined with slight redness of the conjunctiva. The ongoing process is often mistaken for ordinary conjunctivitis.
The main sign of this disease is the allocation of pus along the lacrimal openings during pressure in the area of the lacrimal sac. This symptom is sometimes not detected, which is often associated with previously implemented drug therapy. To clarify the diagnosis, a special collargol test is performed. A drop of a solution of collargolum (3%), which is a coloring matter, is instilled into the child’s eyes. Previously, a cotton wick is inserted into the nasal cavity . The appearance of collargol on the wick after 5 minutes is evaluated as a positive test. It is considered slow if the paint is detected only after 6 or more minutes and negative if the appearance of the coloring matter occurs after 20 minutes. This test is considered positive when, after instillation of the substance, the conjunctiva of the eye enlightens for 3 minutes. A negative result indicates conduction disturbances in the lacrimation system, but cannot determine the nature and level of the lesion. In this case, you can not do without consulting a specialist. A serious complication of dacryocystitis is phlegmon of the lacrimal sacs , accompanied by a sharp increase in temperature and restless behavior of the child. The outcome of the disease is sometimes the formation of fistulas of the lacrimal sac.
In the chronic process, the main symptom of the disease is abundant purulent discharge that fills the palpebral fissure, most often after crying or sleeping. Having established the diagnosis, treatment should be started immediately. First of all, the anatomy of the tear ducts, the projection of the lacrimal sac are studied. Before massage, wash your hands, cut your nails. You can use sterile medical gloves during the procedure.
1. Purulent discharge squeezed out of the lacrimal sac.
2. A solution of furatsilin, heated to body temperature (1: 5000), is instilled into the eyes.
3. A purulent discharge is removed with a cotton swab.
4. A massage is carried out in the area of the lacrimal sacs by careful pressure with the index finger 5 times from top to bottom in order to break through the film.
5. Disinfectant drops (Vitabact or 0.25% Levomycetinum) are instilled.
6. Such manipulations are carried out 4-5 times daily.
Massage should be performed for at least 2 weeks. The gelatinous film breaks or resolves in 3-4 months (if all recommendations are correctly followed).
If purulent discharge from the eyes does not stop, it is necessary to probe the nasolacrimal duct. This procedure is performed in the eye cabinet. This is a complicated and painful procedure. It is performed using local anesthesia. After probing for 1 week, the foregoing massage is mandatory. Purulent discharge with dacryocystitis is observed in 5% of newborns.