About 5% of babies face the problem of blockage of the lacrimal canal. In some cases, the congenital disease goes away on its own, in others, qualified assistance is required. Pathology is characterized by impaired patency of the lacrimal duct and inflammation of the lacrimal sac. With dacryocystitis in newborns, probing of the lacrimal canal is performed, as well as alternative methods of treating this disease.
Probing is an effective and safe procedure
Reasons for obstruction of the lacrimal canal
The factors that can provoke dacryocystitis are quite diverse. The most common of these is congenital obstruction of the tear ducts. In this case, babies are born, already having this disease. A similar condition can be caused by underdevelopment of the ducts, improper formation of the structure of the skull and face. Another reason is infections and inflammation of the ducts themselves, as well as the eyes and nose. In addition, facial injuries that affect the tear ducts and the bone near them can cause blockages. Dacryocystitis in a child in some cases develops as a result of the formation of tumors and growths in the lacrimal canals.
Quite often, blockage of the nasolacrimal ducts occurs for the reason that after birth, the baby does not rupture the thin membrane that protected the eyes from the ingress of amniotic fluid during pregnancy. For life in the outside world, it is not needed and now only interferes with the normal outflow of tear fluid. As a result, it stagnates, which leads to inflammation of the lacrimal sac and the accumulation of pus.
The reasons for the development of dacryocystitis
The disease occurs due to a narrowing or blockage of the lacrimal duct caused by inflammation in the sinuses, nasal cavity and bone tissue surrounding the lacrimal sac.
The reasons for the development of pathology can be divided into 2 groups:
- Factors associated with impaired development of the lacrimal canals. This category includes congenital causes:
- Incorrect formation of the skull, nose, eyelids, eyes;
- Genetic diseases that have led to a violation of the structure of the face;
- Narrow and short duct.
- Factors arising from other problems in the normal development of the nasolacrimal ducts:
- Blockage of the canal due to the formation of a tumor or growth in the canal;
- Obstruction of the ducts due to the presence of plugs in them (viscous secretion, embryonic tissue);
- Maintaining the integrity of the protective membrane;
- Eye infection (development of adhesions due to inflammation).
Blockage of the lacrimal canal
How can you clarify the diagnosis
To establish an accurate diagnosis and the cause of dangerous symptoms, you must do the following:
- Conduct an examination to assess the condition of the eyes.
- Take a swab for infection.
- Make a tubular test. To do this, collargol (dye) is instilled into the eyes. Within 5 minutes, it should dissolve in the tear fluid. If after the specified time the pigment has not disappeared, it can be assumed that the passage of the channels is difficult. If the substance does not dissolve for more than 10 minutes, then we are talking about obstruction of the tear ducts.
- Conduct a nasal test Vesta. It is carried out by analogy with the tubular. The only difference is that a cotton tourniquet is placed in the nostril. If there are problems, the material will be colored with pigment only after 5 minutes, if there is no outflow at all, staining will not occur.
Important! In any case, if a pathology is suspected, immediate consultation with an ENT doctor is required.
The assumption of the presence of a disease or infection that can cause pathology should arise in such cases:
- Increased tearing;
- Inflammation of the eyes;
- Discharge of mucus (appears after sleep);
- Discharge of pus (accumulates in the inner corner, then a purulent sac forms);
- Painful sensations (the baby begins to cry if he touches the sore eye);
- Swelling in the corners of the eyes;
- Puffy eyelids;
- Blurred vision;
- Redness of proteins;
- Lacrimal congestion (even if the baby does not cry, you can see accumulated tears in the lower eyelid).
On a note. Discharge from the eyes can be yellowish, green, whitish. The specific option depends on the stage of the pathological process.
If you don't take any action, your symptoms will only get worse. Inaction will lead to the development of phlegmon (pathological focus in the subcutaneous fat). Pus can come out, get into the sinuses and even the brain, provoking the development of meningitis.
Lacrimal canal: rate and blockage
Indications for sounding (bougienage)
Eye probing in an infant is required in such cases:
- The pathology became chronic;
- The child has intense lacrimation;
- Conservative treatment was not successful after 2 weeks;
- The presence of congenital malformations of the nasolacrimal ducts.
Preparing your baby for sounding
Probing the lacrimal canal in infants is a fairly simple procedure, the purpose of which is to restore fluid patency. The manipulations are quick and painless.
Preparation for surgery includes the following steps:
- Visit to an otolaryngologist. The doctor must exclude the curvature of the nasal septum. In the presence of this defect, the procedure will be useless. You also need to make sure that the baby does not suffer from infectious diseases that could provoke a blockage of the channels.
- Complete blood count and clotting test. It is important that the child does not bleed heavily during the operation.
- Before starting the operation, the baby should not be fed, otherwise the baby will spit up during the procedure.
- Swaddling the baby is tight enough so that he cannot prevent the doctor from carrying out all the necessary manipulations.
- It is advisable that the child gets enough sleep and is in a good mood.
How is the operation performed
The procedure is carried out in a hospital, takes about 10 minutes and is performed using local anesthesia. The operation includes several stages:
- Anesthesia. To do this, the problem eye is treated with anesthetic drops.
- Probing. A Sichel probe is inserted into the canal, which dilates the tear ducts.
- A longer Bowman probe is then inserted. The end of the device reaches the required depth, pierces the membrane and dense tissue accumulations.
- Washing. The device has an opening through which the channel is cleaned with sterile liquid. The ducts are disinfected.
On a note. During the procedure, the child does not feel pain, but most often he cries, as he is afraid of the manipulations carried out with him.
Postoperative care
At the end of the procedure, the doctor prescribes a massage of the lacrimal canal for the child, and also prescribes anti-inflammatory drops.
So, the list of necessary actions after the operation looks like this:
- Avoid the likelihood of contracting ARVI (if the child gets sick, the blockage of the ducts may recur).
- During the week, massage the lacrimal canals.
- For 7 days, bury the eyes with special drops.
Massotherapy
Contraindications for conducting
There are several reasons for refusing the procedure:
- Curvature of the nasal septum. In this case, probing the newborn's eye is useless; the child needs another operation.
- Severe purulent inflammation of the lacrimal sac, spread of the focus of infection to the surrounding tissues.
Possible complications
Since probing is a surgical procedure (albeit quite simple), some complications are possible after it. One of the most common undesirable consequences is a scar that occurs at the puncture site of the tear duct. Under such conditions, the risk of recurrence of dacryocystitis increases. In some cases, an individual negative reaction of the child's body to local anesthesia is possible.
Indications for reoperation
When and why should a re-probing be done? Almost all the procedures performed have a favorable outcome. It rarely happens that the desired positive effect of the operation is not achieved. In this situation, the baby is monitored by a doctor for a month, then sent for re-probing.
The effect of the procedure may be absent for the following reasons:
- Misdiagnosed;
- The probe has not reached the membrane (insufficient insertion depth);
- After the procedure, a scar remained, which again blocked the canal and provoked inflammation.
If the first procedure did not bring the desired result for one of the last two reasons, the baby should be re-probed.
Other treatments for the disease
According to the well-known pediatrician E. Komarovsky, in most cases, the problem of clogging of the lacrimal canals is solved without surgery. To do this, you need to learn how to massage and carry out it regularly.
At the first treatment with the problem of blockage of the lacrimal canals in a baby, the doctor usually prescribes conservative treatment methods:
- Massage course;
- Eye wash;
- Instillation of drops.
Only if the options presented did not have the desired effect, the newborn is prescribed an operation.
Therapeutic massage, as well as preparation for it and subsequent actions are performed as follows:
- Before the procedure, you must thoroughly wash your hands, wipe dry with a clean towel. In this case, the nails should be trimmed and filed (this will eliminate injury to the skin and mucous membranes of the eye).
- Circular movements are performed with the little finger.
- After the manipulations, the child's eyes need to be rinsed, cleaned of secretions. For this, a solution of chamomile, tea leaves, Furacilin solution are suitable.
- Drip eyes with special antibacterial drops. It is advisable to do this before bed.
Probing the lacrimal canal in newborns is a fairly simple, but at the same time, a very serious procedure. In most cases, there is a positive outcome. Among the favorable aspects of this operation is the speed of its implementation, painlessness.
