Signs, detection and treatment of dacryocystitis in children

Dacryocystitis is an inflammatory process in the lacrimal sac, which often takes a chronic course. Dacryocystitis in children is isolated in a separate form of the disease, therefore treatment of dacryocystitis in children requires a special approach.

Due to the development of inflammation in the nasal cavity and its sinuses and bones that surround the lacrimal sac, there is a blockage and narrowing of the passage in the tear-nasal canal. This provokes a delay and subsequent development of pathogenic microorganisms there, which leads to inflammation of the mucous surface. Dacryocystitis in children immediately after birth, usually develops because of the preservation of the embryonic film, designed to block the lower part of the tear-nasal canal.

Causes of the development of the pathology of

The main causes of dacryocystitis are the breakdown of the breakthrough of the embryonic film. When the child is in the womb, the outlet of the canal is covered with a film, which, under normal circumstances, breaks out immediately after birth. If this did not happen, the newborn develops dacryocystitis.

The lacrimal gland is responsible for the production of a lacrimal fluid that subsequently penetrates the conjunctival cavity, and from it the fluid passes through the lacrimal ducts into the lacrimal sac and then flows into the nasal cavity.

The lacrimal sac is located near the inner corner of the eye, and in the nasopharynx there are a large number of folds that prevent the infection from entering the nose. In infants, this canal is not long enough, and its valves are not fully formed - which creates favorable conditions for infection.

Dacryocystitis also develops when pathological narrowing of the canal is eliminated, when it is clogged with dead cells or mucus due to a disruption in the structure. Parents often ask doctors if dacryocystitis can pass by itself. If in the first few weeks after the birth of a child the patency of the lacrimal canal does not recover independently, then a pathogenic microflora is formed in it, so the development of inflammation begins.

Signs of development of pathology

Experts believe that the obstruction in the lacrimal canal can be both congenital and acquired. More often the disease runs in a chronic form.

Chronic dacryocystitis in the child manifests itself through frequent persistent lacrimation, the development of a tumor in the area of ​​the lacrimal sac. As a result of pressure on the tear sack, a purulent or mucopurulent fluid is released. In addition, there is redness of the semilunar fold, conjunctiva of the eyelids. In the process of washing the lacrimal canals, the liquid does not enter the nasal cavity. With the continued development of the chronic form of the disease, a strong stretching of the lacrimal sac may form, then the skin over it becomes thinner and it shines through it in bluish shades. Chronic dacryocystitis carries a constant threat to the eye, because pus can at any time infect the cornea and provoke the development of ulcers.

In acute incidence of dacryocystitis, children develop swelling and pain, as well as severe reddening of the skin in the area of ​​the lacrimal sac. Eyelids swell, and the eye gap narrows until completely closed. According to its clinical signs, the pathology is similar to erysipelas, but unlike it there is no sharp transition between the inflammatory focus and normal skin. A dense swelling forms in the zone of the lacrimal sac, which after a few days softens, the skin over it turns yellow and an abscess is formed. There is a risk of opening such an abscess. Subsequently, the manifestations of inflammation subside, but may appear fistula with the release of tears or pus.

Diagnosis of pathology

In order to establish the correct diagnosis, the physician analyzes the patient's complaints and finds out when the discharge from the eyes and lacrimation began, how the symptomatology changed depending on the time, whether any treatment was carried out and when it was started. The specialist must necessarily show the mother of the affected child the technique of implementing a special massage.

When performing an external examination, the physician identifies the presence of tearing or lacrimation in the eye, provided that the child is at rest at this moment. It is also necessary to pay attention to the presence of protrusion near the inner corner of the eye, the skin in the eyelid zone, the presence of redness and swelling, and also assesses the condition of the eyelids, the process of eyelash growth, the presence of lacrimal points and the nature of discharge when the tear sacks are pressed.

Depending on the nature of the secretions, the diagnosis of the type of infectious agent is made, and the volume of secretions indicates the size of the lacrimal sac. After extruding the contents, color samples are organized.

The tubular sample provides an opportunity to evaluate the function of suction of lacrimal points, tubules and lacrimal sac. For this, two drops of collagolum with a concentration of 3% are instilled in the eye.

In the course of diagnosis, it is mandatory to conduct a study of the detachable in order to establish the type of pathogen and sensitivity to certain antibiotic drugs.

Additional methods of examination include endoscopy of the nasal cavity, sounding and washing of lacrimal ducts. The same procedures are conducted with a therapeutic purpose.

In addition to these methods of diagnosis for children with suspected dacryocystitis, it is necessary to donate blood to a general analysis to exclude the presence of ARVI, allergic reaction and other pathologies in the body.

Treatment process

The process of treatment of dacryocystitis involves the organization of restoration of normal patency in tear ducts, elimination of inflammation, as well as disinfection of the system of lacrimation. Treatment should be started as soon as possible.

With the development of dacryocystitis in newborns, treatment begins with a lachrymal massage. The mother must master the correct technique of conducting it, otherwise the method will not bring results.

In acute forms, eye drops are shown for dacryocystitis, UHF exposure to the lacrimal sac, antibiotic treatment. If softening occurred, then an autopsy and drainage of the abscess is performed. In addition, children with disinfectants and antibacterial drugs are used for the disease.

Initially, to clean the cavity it is washed with a decoction of chamomile or a solution of furicillin.

The treatment with antibiotics depends on the results obtained after the organization of the microbiological examination of the secretions and the establishment of the sensitivity of the child's organism. In newborns in 95% of cases, pathology provokes staphylococcus and occasionally - Pseudomonas aeruginosa or streptococcus.

The use of albucid for children is undesirable, since it causes burning sensation and can crystallize, which further complicates the outflow of fluid from the nasal cavity.

If the proper organization of the massage for one to two weeks did not produce the expected effect, lacrimal canal sounding is required. The most suitable age for such an event is one to three months. In this case, a mechanical rupture of the embryonic film occurs due to a special probe.