Acute and chronic dacryocystitis in children - symptoms, treatment
Congenital dacryocystitis in children is a pathology caused by an abnormality in the development of the nasolacrimal duct. It occurs in 1-5% of children and in the absence of treatment can lead to the transition of the process into a chronic form. Secondary dacryocystitis develops, as a rule, against the background of sinusitis, chronic rhinitis, after SARS, with damage to the tear ducts, with fractures of the bones of the nose and orbit, polyps of the nasal cavity.
Causes of dacryocystitis
The congenital form develops when there is an abnormality in the development of the nasal outlet of the nasolacrimal duct, which in this case ends with a blind sac. This is due to the fact that the film that closes the duct during fetal development remains intact and does not tear during the first breath of the newborn. As a result, there is no normal outflow of tear fluid into the nasal cavity, the tear is retained in the duct, in which stagnation occurs. This creates a favorable environment for the growth of pathogenic and opportunistic microbes that cause inflammation. Microorganisms most often enter the canal at the time of childbirth from the mother's genital tract.
Symptoms of dacryocystitis
In the first days of a newborn's life, a small amount of muco-purulent discharge appears in the eye area. Over time, this number increases, and the discharge becomes more frequent. Most often, the disease goes away on its own, because due to the inflammatory process, the preserved film thins and at some point breaks. In this way, the outflow of tears through the nasolacrimal canal is restored.
If the film is preserved, the process becomes chronic, and then specialized treatment cannot be dispensed with. Refusal of treatment or self-medication can cause complete obstruction of the nasolacrimal duct due to adhesions, adhesions, narrowing of its lumen, as well as lead to conjunctivitis, phlegmon of the lacrimal sac and orbit, keratitis with subsequent permanent loss of vision, sepsis.
That is why the website dobrobut.com recommends to consult an ophthalmologist as soon as possible at the slightest signs of trouble in the organ of vision.
Treatment of dacryocystitis in children
The purpose of treatment of this disease:
- restoring the patency of the nasolacrimal canal;
- removal of infection;
- suppression of the inflammatory process;
- prevention of complications and treatment of those that have already arisen.
With timely referral to a specialist, conservative therapy is sufficient.
Treatment begins with massaging the lacrimal sac, during which the specialist squeezes its contents towards the nose with vigorous movements. The doctor teaches the parents this manipulation, which must be performed every day. Twice a week it is conducted by an ophthalmologist, at the same time monitoring its effectiveness. If there is no effect from the massage, the doctor resorts to washing the tear ducts.
Within a month, this procedure, which is performed using a special syringe, is quite capable of leading to success. If this does not happen, then retrograde probing of the nasolacrimal canal with a special thin probe is carried out from the age of two months. Usually, after the first procedure, pus and lacrimation disappear within 2-3 days. The child does not need further treatment. Sometimes it may be necessary to repeat the sounding after 5-7 days.
The lack of effect from retrograde probing, performed at least 3 times, forces the doctor to switch to probing through the upper lacrimal point - the entrance to the nasolacrimal duct from the side of the eye. The procedure is recommended for babies from the age of four months, and is carried out 3-4 times with a weekly interval.
All the listed manipulations are performed for dacryocystitis in children under one year. If none of them were successful, it is considered that the process has become chronic and then doctors take a wait-and-see position until the child reaches 2.5-3 years. After that, an operation is performed during which the connection between the nasolacrimal duct and the nasal cavity is reconstructed. Such a long wait is explained by the fact that the baby's facial skull continues to form, and if operated on too early, the created outlet may close due to changes in the shape of the baby's facial bones.
Dacryocystitis is a disease with a favorable prognosis and can be cured by carefully following the doctor's recommendations. Do not delay a visit to a specialist at the first signs of illness. Then the probability of quick treatment is maximum.
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