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Pathologies of the lacrimal system

Treatment of pathology of the lacrimal drainage system at the K+31 clinic.
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About the disease

The lacrimal ducts begin with the excretory ducts of the lacrimal gland and the glands of the conjunctiva. The tear fluid secreted by the lacrimal glands washes the anterior part of the eyeball, then flows along the lacrimal stream located along the inner edge of the eyelids to the inner corner of the eye, where the lacrimal puncta are located on the inner parts of the edges of the eyelids. Further, through the upper and lower lacrimal canaliculi, it penetrates the lacrimal sac and ends its path in the nasal cavity, where the nasolacrimal duct opens under the inferior nasal concha.

Impaired patency of the lacrimal ducts leads to impaired tear drainage and the occurrence of lacrimation, which can increase under the influence of cold and windy weather and decrease in a warm, dry room.

The causes of impaired lacrimal drainage may be:

  • Displacement of the lacrimal punctum (for example, with eversion of the eyelids).
  • Obstruction along the lacrimal ducts from the lacrimal punctum to the nasolacrimal duct.
  • Impairment of the tear suction mechanism, which can occur due to sagging of the lower eyelid or weakness of the orbicularis oculi muscle (for example, with facial paralysis).
About the disease
Diagnostics
Diagnostics
  • fluorescein tests
  • probing and washing the lacrimal ducts
  • contrast dacryocystorhinostomy
General information about the treatment of pathologies of the lacrimal drainage system

Stenosis of the lacrimal punctum. Treatment of lacrimal punctal stenosis

Stenosis of the lacrimal punctum occurs in the absence of its eversion due to:

  • chronic blepharitis;
  • herpetic lesions of the eyelids;
  • cicatricial conjunctivitis or trachoma;
  • spread of malignant tumors.

During the treatment process, as a rule, the following is carried out:

  • expansion of the lacrimal punctum with a dilator probe;
  • surgical operation - plastic surgery of lacrimal openings.

Obstruction of the lacrimal canaliculi and nasolacrimal canal. Treatment

Obstruction of the lacrimal canaliculi - can be congenital, or also occur due to injury, infection and inflammation of the lacrimal canaliculi, or radiation.

In case of partial obstruction, intubation of the lacrimal canaliculi is performed; in case of complete obstruction, a surgical operation (canaliculodacryocystorhinostomy) is performed with the imposition of anastomoses (communications) between the canaliculus and the lacrimal sac.

The causes of obstruction of the nasolacrimal duct may be nasoorbital trauma, surgical interventions on the nose and sinuses, and germination of nasopharyngeal tumors.

Surgical treatment – dacryocystorhinostomy.

Chronic canaliculitis. Treatment of chronic canaliculitis

Chronic canaliculitis is an infectious inflammatory disease of the lacrimal tubules. It manifests itself as unilateral lacrimation with chronic mucopurulent conjunctivitis, not responsive to conventional treatment. Characteristic features include swelling of the lacrimal punctum, swelling and redness of the area of the lacrimal canaliculi, and the presence of mucopurulent discharge when pressing on their area.

Treatment of chronic canaliculitis is based on:

  • local antibiotic therapy (ciprofloxacin);
  • canaliculotomy.

Acute dacryocystitis. Treatment of acute dacryocystitis

Acute dacryocystitis is an infectious inflammation of the lacrimal sac, usually associated with obstruction of the nasolacrimal duct. It manifests itself as a painful, tense swelling in the inner corner of the palpebral fissure, and lacrimation. In severe cases, an abscess may develop.

Chronic dacryocystitis may be associated with chronic and worsening conjunctivitis. A painless swelling appears in the inner corner of the eye, and when pressed, mucopurulent discharge is released through the tubules.

Treatment of dacryocystitis is based on:

  • general antibacterial therapy;
  • when a secondary infection joins the inflammatory process, which causes an abscess (abscess formation) - opening and draining the abscess;
  • dacryocystorhinostomy.

Dacryocystitis of newborns. Treatment of dacryocystitis in newborns

Congenital obstruction of the nasolacrimal duct often occurs as a result of delayed restoration of its patency due to the presence of a gelatinous plug or film in the nasolacrimal duct, which usually resolves by the time the child is born. Occurs in more than 20% of newborns.

Dacryocystitis of newborns - manifested by severe lacrimation and lacrimation. When pressing on the area of the child's lacrimal sac, mucopurulent contents are abundantly released from the lacrimal openings.

In most cases, the problem resolves itself. In case of persistent severe lacrimation and copious discharge, massage of the lacrimal sac area or probing of the lacrimal ducts with rinsing with antiseptic solutions is prescribed.

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K+31 on Lobachevskogo

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+7 499 999-31-31
K+31 Petrovskie Vorota

1st Kolobovsky lane, 4

74999993131
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Orshanskaya, 16/2; Ak. Pavlova, 22

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