Eye diseases. Inflammation of the tubules and lacrimal sac (most important)

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Eye diseases. Inflammation of the tubules and lacrimal sac (most important)

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16. Inflammation of the tubules and lacrimal sac

With canaliculitis, there is a slight swelling in the area corresponding to the lacrimal openings and tubules. In addition, hyperemia of the skin, lacrimation and purulent discharge are revealed, and when pressing on this swelling with a finger or a glass rod, a mucous or purulent plug is released from the lacrimal opening. In some cases, the squeezed out contents of the tubule is a crumbly yellowish secret containing grains of fungal calculus. It is necessary to subject the discharge to bacteriological examination.

Treatment. Antibiotics and sulfonamides are used locally; sometimes dissection of the affected tubule is used, scraping out the contents with a sharp spoon, followed by treatment of the cavity with a 12% solution of lapis, iodine tincture.

Dacryocystitis inflammation of the lacrimal sac. It occurs in acute and chronic form.

When examining children in the first weeks of life, a slight lacrimation and lacrimation are sometimes detected, and in some cases a purulent discharge is detected. If, moreover, when pressing on the area of the lacrimal sac, the mucous or purulent contents of the sac are released from the lacrimal puncta into the conjunctival cavity, then the diagnosis of neonatal dacryocystitis becomes obvious. If dacryocystitis exists for a long time, then a strong stretching (dropsy) of the lacrimal sac occurs, swelling is observed, a significant protrusion of tissues in the area of the lacrimal sac.

Often, dacryocystitis is complicated by the development of phlegmon of the lacrimal sac. At the same time, pronounced swelling and a sharp painful infiltration of surrounding tissues appear. The palpebral fissure may close completely.

The development of chronic dacryocystitis occurs due to stenosis of the nasolacrimal duct, leading to stagnation of the tear and the detachable mucous membrane of the lacrimal sac. There is a gradual stretching of the wall of the bag. The contents accumulating in it are a favorable environment for the development of pathogenic microflora (streptococcus, pneumococcus, etc.). The transparent secret of the cavity of the lacrimal sac becomes mucopurulent. The most common damage to the lacrimal openings and tubules in wounds of the eyelids.

Clinical picture and diagnosis. Complaints of persistent lacrimation, purulent discharge from the eye. There is an excess of tears along the edge of the lower eyelid, a soft protrusion of the skin at the inner edge of the eye. When pressing on the area of the lacrimal sac, mucous or mucopurulent contents flow abundantly from the lacrimal openings. The lacrimal sac may be so distended that grayish contents show through the thinned skin. This condition is called dropsy of the lacrimal sac.

For diagnosis, biomicroscopy, tubular and nasal samples are used.

Treatment. Chronic dacryocystitis is treated only surgically. A dacryocystorhinostomy is necessary to create a direct fistula between the lacrimal sac and the nasal cavity.

Author: Shilnikov L.V.

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