Eye diseases. Inflammation of the lacrimal gland (most important)

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Eye diseases. Inflammation of the lacrimal gland (most important)

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15. Inflammation of the lacrimal gland

With the pathology of the lacrimal gland, there may be increased tearing or, conversely, dry eyes. However, pain and size change are more often determined. There are dacryadenitis in the form of sharp inflammatory changes in the eyelids and conjunctiva or cysts of the lacrimal gland, resembling translucent tumors of various sizes.

Palpation of the lacrimal gland area is performed through the skin of the upper eyelid, while determining its consistency, size and location.

More often, changes are noted in the lacrimal ducts. The study of their condition begins with examination of the lower lacrimal opening. It usually faces the eyeball and becomes visible if you bend the lower eyelid slightly. Atresia of the lacrimal openings, their dislocation, and narrowing may be detected, which is accompanied by impaired absorption of tears and the appearance of lacrimation. In old age, inversion of the lacrimal punctum is often observed. If there are no changes in the lacrimal opening, then lacrimation may be due to pathology of the lacrimal canaliculi or other parts of the lacrimal ducts. To determine the state of the main function of the lacrimal ducts (the passage of tears through the lacrimal canaliculi and its discharge into the nose), a color test is used. Passing a blunt needle or conical probe into the lacrimal sac before washing it also serves as a diagnostic technique, as it allows one to judge the presence of narrowing of the tubule or obstacles in it. Rinsing is carried out after instillation of a 0,5% solution of dicaine (1% lidocaine) into the conjunctival cavity. Dacryoadenitis is inflammation of the lacrimal gland.

It can be both acute and chronic. It occurs mainly due to endogenous infection with measles, scarlet fever, mumps, typhoid fever, rheumatism, tonsillitis, influenza. The process is often one-sided.

If in the lateral part of the upper eyelid, according to the localization of the lacrimal gland, there is swelling and the upper eyelid acquires an S-shape, palpation in this area is marked by compaction and pain, swelling of the mucous membrane of the eyeball is noted (chemosis), sometimes yellowish areas of suppuration of the gland or opened abscesses on the side of the conjunctiva, purulent contents are released into the conjunctival cavity, and upward and outward mobility of the eye is limited, regional lymph nodes are enlarged and painful, this indicates dacryoadenitis. Sharp swelling, pain, redness of the outer part of the upper eyelid. The palpebral fissure takes on a changed shape. Redness and swelling of the conjunctiva of the eyeball in the upper outer region are noted. There may be a downward and inward displacement of the eye and a limitation of its mobility. The preauricular regional lymph nodes are enlarged and painful. However, more often the disease is benign.

The goal of treatment is to combat the common disease. In an acute process, antibiotics are prescribed (ampicillin, oletethrin, metacycline in four to six doses), sulfonamides, and symptomatic agents.

Author: Shilnikov L.V.

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