Dacryocystitis called inflammatory or purulent inflammation of the area of the lacrimal sac and nasolacrimal duct discharging tear. Dacryocystitis occurs due to congenital or acquired stenosis (narrowing) or complete overlap of the output of the lacrimal duct.
Dacryocystitis is most common in infants and children during the first months of life because of the inherent features of the nasolacrimal duct structure. By the birth of the baby if the membrane tissue membrane may remain inside the channel is not completely resolved. Because of this broken lacrimal fluid outflow, and the contents of stagnation quickly infected by microbes.
Among adults, dacryocystitis often affects women because of the narrow nasolacrimal channels, use cosmetics.
Kinds
Adrift allocated acute dacryocystitis, which can give the development purulent abscesses or abscesses, and chronic dacryocystitis.
According to the leading causes of release:
- viral,
- microbial, parasitic,
- chlamydial,
- traumatic,
- rarely allergic dacryocystitis.
Separately allocated dacryocystitis of newborns.
Causes
neonatal dacryocystitis caused by:
- innate sharp narrowing of the lumen of the nasolacrimal duct,
- the presence of the membrane inside the channel of the move,
- gelatinous cork is not resolved in utero,
- atresia entire channel (fully zaroschenny duct).
Adults dacryocystitis causes:
- swelling of surrounding tissues at a cold, sinusitis, nasal polyposis,
- injury channel with nasal fractures or bone orbit
- wound age, region nasolacrimal canal zone lacrimal points,
- purulent or viral infections of the eye,
- Eye foreign bodies, sand, dust.
Factors predisposing to the development of the disease are:
- sugar diabetes , and other metabolic diseases,
- allergyEspecially in the form of rhinitis and conjunctivitis,
- a general decline in the immune defense,
- occupational hazards dangerous to the eye - caustic and volatile compounds,
- sudden temperature fluctuations.
The mechanism of occurrence
As a result of disruption of the tear fluid circulation nasolacrimal drainage channel and normal tears into the nasal cavity, there is a stagnation of fluid in the channel cavity. It is a breeding ground for bacteria attachment, always somehow fall to eyes and rinse-off of the tear fluid. It occurs microbial growth and formation of purulent inflammation. inflammatory cavity abscess occurs may be formed in the walls of the channel region. If the channel walls do not limit the spread of infection, abscess may occur.
When injected into the tear fluid of viruses, allergens or chlamydia, Specific inflammation is formed inside the nasolacrimal duct.
The chronic form is developed by narrowing the nasolacrimal duct due to the periodic content stagnation and formation of irritation and inflammation, swelling of the channel walls.
manifestations dacryocystitis
Acute dacryocystitis usually shows:
- the formation of a painful tumor in the lacrimal sac,
- sharp redness in the nasolacrimal duct,
- swelling of the century, the narrowing of the optic fissure,
- in the orbit of the pain,
- temperature increase
- signs of intoxication.
Swelling in the first few days of illness dense, then softened. Redness subsides abscess is formed with opening to the outside. After the swelling of pus inflammation passes. Can form a fistula through which the bag contents will flow away and the channel.
Chronic Dacre appears:
- persistent and excessive tearing,
- Tumor formation in the projection of the lacrimal sac,
- when a mild swelling in the pressure-sensitive region is formed by selection or purulent mucus content in lacrimal points,
- forever in the inner corner of the eye red and swollen,
In the long process of the lacrimal sac cavity expands, the skin over it is thinning.
Symptoms of neonatal dacryocystitis
- expiration of tears from the eyes,
- purulent discharge from the eyes,
- eyelid edema.
Danger is the presence of purulent process in the vicinity of the eyes, nose and sinuses, brain. The spread of infection to adjacent organs can lead to serious complications.
Diagnostics
diagnostic base - is the complaints and clinical manifestations of dacryocystitis. Needs inspection and delicate feeling of the area of inflammation, the presence of purulent discharge from the lacrimal points. Additionally held:
- determining patency lacrimal system by introducing colorant (Collargol) in the eye with its detection on a cotton swab, introduced into the nasal cavity.
- diagnostic probe the nasolacrimal duct,
- passive nasolacrimal sample with washing.
- biomicroscopy of the eye,
- instillation test with fluorescein (instillation glowing special reagent)
- crop discharge from the channel to the study of microbial accessories and definition of sensitivity to antibiotics,
- with the contrast radiography, introduced into the nasolacrimal duct.
- appointed consultation ENT doctor, if necessary, the maxillofacial surgeon (with injuries).
dacryocystitis treatment
Diagnosis and treatment of dacryocystitis engaged ophthalmologists.
In the acute form
Drug of choice:
- Cefuroxime inside;
- local therapy - fusidic acid or chloramphenicol (drops).
Alternative products:
- tetracycline,
- doxycycline,
- ofloxacin or levofloxacin.
Antibiotics given the sensitivity of the crops.
Adjunctive therapy:
- is used in the form of local therapy solljuks lamps or UHF,
- the formation of abscess - dissection and washing of purulent cavity,
- after decrease inflammation, plastics and formation of a new channel.
chronic dacryocystitis treated surgically:
- made of plastic and forming the nasolacrimal duct,
- channel extension,
- in some cases, removing the lacrimal sac.
When neonatal dacryocystitis used
- massage of the nasolacrimal duct to extrusion content (often breaks through the membrane and normalizes outflow).
- rinsing solution or colloid silver Albucidum,
- nasolacrimal duct probing,
- After three months, carry out surgery.
With timely beginning of treatment the prognosis is favorable, it is possible to achieve a complete cure. In advanced cases of dacryocystitis is prone to relapses.
