Probing of the lacrimal canal in children is why it is prescribed. Probing of the lacrimal canal. Indications for medical manipulation

Probing of the lacrimal canal in newborns is an ophthalmic operation in which the gelatinous film is eliminated, which does not let the lacrimal secret into nasal cavity. Blockage of the lacrimal canal often causes inflammation, as not only the tear sacs accumulate in the lacrimal sacs, but also pathogens. The resulting conditions are favorable for them and they begin to multiply. This in turn provokes purulent inflammation.

IN normal conditions the lacrimal canal opens on its own, and the gelatinous film breaks through with the first cry of the newborn. But in rare cases - about 5% of all born children - pathology is detected. The secretion of tears is an important process that performs moisturizing and protective function for eyes. Without them, or with an insufficient volume of secretion, visual acuity decreases significantly over time. And here is how sounding occurs in a newborn with dacryocystitis, this will help to understand

What is it for - probing the lacrimal canaliculus of the eye in newborns

The cause of the development of inflammation is a blockage of the lacrimal canaliculus. During intrauterine development, the film protected the eyes, Airways and the nose of the fetus from the ingress of amniotic fluid into them. When it appears on the account and the first breath and cry, it breaks through. If this does not happen, then tearing is disturbed, inflammation develops due to the accumulation of secretion in the lacrimal sac and the reproduction of the pathogen there.

At first, doctors recommend coping with the problem therapeutic methods. These include massage and medication. This approach most often justifies itself, but in those rare cases when it was not possible to break through the film with a therapeutic effect, probing of the lacrimal canaliculus in the newborn is prescribed. But how the eyelid massage occurs with demodicosis can be seen in this

On the video - a description of the problem and what it is prescribed for:

Usually the procedure is prescribed from 2-3 months of age, but if the indications are urgent, then it can be carried out much earlier.

With dacryocystitis, there is a risk of not only suppuration of the lacrimal ducts, but also a chronic process. Therefore, it is impossible to delay the procedure in order to prevent future relapses of the pathology in the child.

But how is the diagnosis of presbyopia of the eyes made and how is the treatment of such a disease, indicated

How is it carried out

In order for the operation to be successful, parents must first prepare the child for it. A few days before the manipulation, it is necessary to adjust the child's diet so that the child does not eat for about 3 hours before the operation. This abstinence applies to children under 6 years of age.

Scheme of surgical intervention

It is also necessary:

Refuse medications that are incompatible with anesthesia. Consult your doctor for any medications you use.
You can not use medicines that thin the blood, otherwise the risk of opening bleeding increases significantly and can lead to many complications and death of the patient. But you can read how it happens in the article at the link.
It is necessary to prepare diapers, necessary underwear, tightly swaddle the baby. This helps to prevent unintentional movement of the handle during the procedure.
Preliminarily undergo an examination for the child's contraindications to probing the lacrimal canaliculus. These are primarily low blood clotting, infectious lesions of the eyes, skin around the eyes, on the face and ENT organs. But how the massage of the eyes of a newborn with dacryocystitis is done, you can see
Consult an otolaryngologist regarding the presence of a deviated septum, which can also be the cause of pathology and frequent infections in a child.

On the video - how sounding is carried out:

This manipulation can be carried out both in the clinic and in the conditions of the eye office. The whole procedure is carried out depending on the actions of the doctor, the action of anesthesia and other factors from 5 to 20 minutes. Perform manipulations under local anesthesia, that is, only the area of intervention is anesthetized. This reduces the risk and intensity side effects. But how to apply correctly, the information on the link will help to understand.

If a diagnosis of "dacryocystitis" is made and doctors prescribe probing as a method of treatment, it is impossible to refuse, since there are quite serious indications for this procedure.

But how to use drops from a chalazion in a child correctly, this will help to understand

Painkillers are instilled into the patient's eye twice. When the expected effect is obtained, the doctor inserts a special tool into the lacrimal ducts. The tool has a conical shape - this is the Sichel probe. Thus, the tear ducts expand. Further, with the Bowman probe, the doctor reaches the desired depth and breaks through the barrier. After that, the cavity of the lacrimal sac is washed with saline, which enters the nasal cavity without obstacles, and is disinfected with a light antiseptic.

To make sure that the operation was successful, the doctor instills a special coloring solution into the child's eye and inserts a cotton turunda into the nose. If it is colored after 5 minutes, the procedure is considered successful.

In such cases, it is considered that the conjunctiva has been successfully cleared, and therefore the patient is allowed to go home with the following treatment prescriptions:

The use of antibacterial children's drops for instillation into the eyes for a week. But what drops to use after cataract surgery, this will help to understand
Carrying out massage in the area of the lacrimal ducts.

As statistics show, most of these procedures pass without any complications, and the effect is achieved almost immediately. But there are exceptions when changes do not occur in a month. Therefore, the doctor may decide to re-probing.

If available congenital anomalies or a curvature of the nasal septum, then doing the procedure is pointless. In such cases, other surgical interventions are prescribed.

Consequences for babies

After the operation, some side effects may occur, which are a normal manifestation after the intervention:

A small amount of blood is released from the nose for 5-7 days.
Nasal congestion and sneezing may occur for 1-2 days.
There may be bouts of nausea, vomiting in the first couple of days after surgery.
Also, in the first two days, there may be a slight soreness of the operated area. But what to do when the corner of the eye itches and hurts, you can read
The tearing may last for about 2 weeks.

Rub your eyes and swim the child is allowed without restrictions.

If the symptoms persist for a long time, as well as if there is redness, swelling, discharge from the eye, fever, fever, chills, capriciousness and lethargy in a child, you should immediately consult a doctor.

But how to use drops against glaucoma and which drops are the best, it is indicated

Speaking specifically about complications, probing can provoke the formation of a scar. Accordingly, the scar can cause re-occlusion of the tubule. It may also develop infection eyes. To prevent such a complication, medical prescriptions should be carefully followed.

The birth of a child is one of the best moments that young parents experience. But there are situations when such a positive event is overshadowed by the words of doctors when they say that the child has pathological changes. Probing of the lacrimal canal in newborns, common problem that may be encountered. So that parents do not panic, let's see what the danger of this procedure lies in and whether it is as serious as it seems at first glance.

Causes and features of the disease

Quite often, after the birth of a child or during the birth itself, the baby may experience problems with the eyes. There are many reasons for these changes. It can be both congenital pathologies of the eye, and acquired.

Acquired causes of eye disease

infection of the eyes when passing through the birth canal;
colds;
mechanical injury;
allergic reactions.

emergence pathological changes occurring in the eyes of newborns is difficult not to notice. The main symptoms are redness of the eyes with purulent contents, sticking of the eyelids and unusual discharge, with signs of dryness and peeling. skin around eyes. In addition to violations of the lacrimal canal, the cause of the deviation may be ordinary conjunctivitis or another infection.

But tearing - when a child cries, and his tears do not go beyond the eye, this is the first sign of a violation of the lacrimal canal. While the child is in the womb, the tear ducts are closed with special contents. Nature did this in order to protect the eyes of the child from intrauterine infection. At the time of childbirth or immediately after them, the tear ducts should open on their own, but it also happens that this does not happen. If the ongoing change is ignored, it can cause significant harm to the health of the child.

The need for probing the lacrimal canals

Blockage of the tear duct or dacryocystitis - inflammatory disease lacrimal sac of the eyes, caused by a narrowing of the lacrimal canal or its complete blockage. The development of this pathology can occur at any stage of life, both in infants and in adulthood. In order to confirm this diagnosis you need to consult an ophthalmologist. Specialists do an examination of the baby's eyes and establish a diagnosis, identifying the causes of its occurrence.

When diagnosing a blocked tear duct in the eyes, many parents panic. It is absolutely not necessary to do this, since timely treatment can cope with this pathology. If the cause of the disease is infection or conjunctivitis, it is possible to use conventional eye drops and classic eyewash. In this case, the treatment will be aimed at eliminating the causes of the primary disease.

If the classical method of treatment did not bring positive result, then parents are offered to perform an operation on the lacrimal canal. All parents who are faced with this question ask the same question, is this intervention dangerous? The answer in this case will be unequivocal, no! This operation is completely safe and does not bear any consequences.

Refusal to carry out sounding carries much more danger than performing an operation. Untimely treatment of the existing pathology can cause significant harm to the health of the child. It must be remembered that the organs of vision are very sensitive to the changes taking place in them. Therefore, even a minor infection can jeopardize the quality of life of the baby.

Features of the procedure

Before prescribing an operation, the doctor must make sure that the cause of the pathology is the obstruction of the lacrimal canal. After conducting an in-depth diagnosis and taking into account all the existing symptoms, the doctor decides on the appointment of a surgical intervention to eliminate the existing pathology.

Before setting the date of the operation, the doctor conducts additional methods research. This is done in order to make sure that the child is healthy. As a rule, in this case, change is assigned general analysis urine and blood. If the child has a history of a tendency to allergies, it may be necessary to consult an allergist.

The procedure itself takes place under local anesthesia. I put the child on the operating table, and fix his position. After in open eye an anesthetic is instilled. As soon as the anesthesia takes effect, a special device is introduced into the eye, which breaks the resulting plug. Immediately after completion of the procedure, the eyes are washed antiseptic preparations. During the procedure, the minimum amount of time is spent, no more than 5 minutes.

Topical issues of the topic

Is there a way to avoid the operation?

The operation is appointed, as a last resort, if there are no other methods for resolving this issue. Before you start using drug treatment or decide on an operation, you need to try massotherapy. Stroking movements from the corner of the eye along the nasal septum should help break the resulting plug. Slight pressing movements can push it out of the lacrimal kagal. As practice shows, this species massage has good result In most cases.

Is there a danger from this procedure, can it adversely affect the child's vision?

Modern methods of treatment used in ophthalmology are completely safe. Significant damage to vision will be caused by the absence timely treatment. To prevent this from happening, you should not turn out from the operation. After probing, simple preventive measures that protect the eyes baby. The main complication may be the possibility of infection.

Is it necessary to go to the hospital for probing?

The operation takes place very quickly, for many children it is also done in a polyclinic, if there is an operating room in it. Since it is done only in a sterile room. If the polyclinic does not have a local operating room, then hospitalization may be required.

Probing of the lacrimal duct in newborns is an ophthalmic operation that eliminates the gelatinous film that does not allow protruding tears to pass into the nasal cavity. Usually, the tear duct opens on its own with the baby's first breath and cry at birth. But 5% of children have a pathology.

The secretion of tears is necessary to provide moisture to the eyeball, protection from dirt on the cornea, which can significantly affect visual acuity.

With the development of a child in utero, the eyes are protected by a film stopper that protects the lacrimal canal from the ingress of amniotic fluid. If the film does not burst during birth, fluid begins to collect in the lacrimal sac, serving as a suitable environment for the development of all kinds of bacteria and fungi. Also, the lacrimal canal can be blocked by a curved nasal septum with a congenital anomaly.

If the deficiency is noticed in the maternity hospital, the operation is prescribed at the age of 6 months. Early elimination of pathology provides positive effect in 85 - 95% of cases. After a year, the film gradually hardens, which complicates the treatment. Older children are more likely to relapse, requiring repeated surgery.

Pre-conducted complete diagnostics to exclude diseases with similar symptoms.

Signs of pathology of the lacrimal canaliculus:

the presence of swelling in the corner of the eye from the side of the nose;
lacrimation at a time when the baby is not crying;
purulent or mucous discharge from one or both eyes;
tears come out, but do not flow down the cheeks;
eyelashes often stick together after sleep.

Sometimes the doctor confuses the symptoms with conjunctivitis, prescribing drops that do not bring relief. Then the child is sent for an examination to an eye doctor. Required diagnostics:

consultation of an ophthalmologist, which confirms the blockage of the lacrimal canal in children;
blood test for clotting rate;
biomicroscopy of both or one eye;
bacteriological culture of the contents of the lacrimal sac to determine the cause and response to medications prescribed by the ophthalmologist;
West's test, which allows you to check the patency of the lacrimal duct. A liquid tinted with a special dye is instilled into one or both eyes of the baby, and a cotton ball is inserted into the nasal cavity. If the liquid passes freely into the nose and a spot of paint appears on the cotton wool, then the patency of the tubule is not impaired;
if the studies undertaken are not enough, a consultation of other specialists is appointed.

If obstruction of the lacrimal passage is detected, the doctor recommends probing. Depending on the condition, the baby is prescribed a lacrimal sac massage. It is done by a doctor on an outpatient basis and parents at home.

What provokes the disease

The cause of the obstruction of the channel are:

hereditary pathology transmitted at the gene level;
getting injured;
, blepharitis, tuberculosis;
obstruction caused by syphilis;
curvature of the nasal septum;
atherosclerosis.

The causes of blockage of the lacrimal canal may have congenital or acquired origins.

If not taken curative measures, That purulent discharge can infect the other eye, infect the ear, flow into the brain. Postponing the operation for far-fetched reasons can cause a complication: loss or weakening of vision. If the obstruction of the tear duct is caused by congenital causes, you can help the baby only after reaching the age of six.

How to prepare for the procedure

In order for the probing operation to be successful, it is necessary to properly prepare for it. In a few days, on the recommendation of a doctor, you should adjust the diet so that by the time of the procedure the baby has not eaten for at least 3-4 hours. Such abstinence is required for children under 6 years of age.

You should stop taking medications that are incompatible with anesthesia and drugs that will be used during surgery.
It is advisable to prepare the necessary linen and diapers to tightly swaddle the baby, preventing unintentional movements of the handles during the operation.
It is necessary to consult a pediatrician to exclude inflammatory colds that give similar symptoms.

How is the operation

The procedure is performed under full anesthesia, which usually does not cause complications in children under one year old. If the baby is naughty, one of the parents is allowed to stay with him until the anesthesia begins to take effect.

The procedure with no complications lasts 10-20 minutes. The doctor inserts a metal probe into the lacrimal canal, similar to a wire with a blunt tip. The tool removes the film and expands the passage for the discharge of tears. To check, a sterile saline solution is poured into the hole, which, without delay and obstacles, exits through the nasal cavity in full. When a small patient wakes up after anesthesia, in most cases he feels quite normal. Rarely, there is a slight pain at the probing site, which disappears within 1-2 days.

After a period of time determined by the attending physician, the child should be brought for a second examination, confirming the success of the operation.

If it turns out that the lacrimal canal does not function as expected, a second intervention is required, which is also performed under general anesthesia:

silicone tubes are inserted into the tear ducts to expand the passage to a certain size. They are removed after 6 months. general anesthesia. Surgery passes without complications in 80% of cases;
a special rubber ball is used, which is inserted into the tear duct and gradually filled with saline. The channel is expanding. Then the liquid is pumped out and the rubber product is removed.

Eye care after surgery

To protect the eyes from infection after probing the tear ducts in infants, antibiotic drops are used almost immediately after the procedure. It is recommended to use antimicrobial treatment for 5 to 7 days.

Also a massage is a must. tear ducts and a bag, as shown by the doctor.

It is necessary to prepare a solution of furacilin by putting the crushed tablet in 100 ml of boiled water. After wetting a cotton pad, you should wipe the baby's eyes from the outer edge to the inner. Use a new swab for each eye. With pressing movements of the fingers, walk at least 10 times along the lacrimal canal in the direction of the bridge of the nose. If a slight swelling appears, it's okay.

The baby may experience some phenomena.

Selection a small amount nosebleeds are considered normal for 5 to 7 days.
Sneezing and congestion of the nasal passages is noted for 1-2 days.
Nausea and vomiting may occur within 1-2 days.
Lachrymation sometimes lasts up to 2 weeks.

It is allowed to swim without restriction, to rub your eyes with your fists.

If such symptoms persist for longer, it is recommended to consult a doctor - a second operation may be required.

Possible Complications

Although the intervention does not affect the surrounding organs, no incisions are made with the formation of scars, complete security cannot be guaranteed.

You should contact without delay medical care if the consequences of the operation are observed:

bleeding from the lacrimal canal;
severe redness of the eyeball;
discharge of cloudy or from under the eyelids;
fever, fever;
the child became lethargic, capricious.

How do children react to anesthesia?

every tenth child has nausea, dizziness, headache within 2-3 days after the operation;
1% has a slight manifestation.

Summary

The success of the operation to free the lacrimal canal from the film that interferes with the free outflow of tears depends on joint efforts doctor and parents. Do not try to solve the problem yourself. The longer the operation is delayed, the more unpleasant consequences may develop.

Obstruction of the nasolacrimal duct is a problem that affects about 5% of newborns. This congenital pathology can go away on its own, even before going to the doctor. Such cases in this medical statistics not reflected. Nothing is known about them. Every twentieth infant who is diagnosed with such a diagnosis is a case where the blockage has not gone away on its own. One way to deal with the problem is a special lacrimal canal massage. The well-known pediatrician Yevgeny Komarovsky tells about how to do it and what should be taken into account.

About the problem

With a normal structure of the eye eyeball when blinking, it is wetted with tears. This protects the organs of vision from drying out and provides visual function. The tear, so necessary in this process, is produced in the lacrimal gland, accumulates in the lacrimal sac, where it enters through the tubules. Other pathways (nasolacrimal) exist so that tear fluid can exit through the nasal cavity. illustrative example This is sniffing while crying.

With obstruction of the lacrimal or lacrimal canals, the outflow is difficult. As a result, the child often develops signs of conjunctivitis. Parents who are unaware of true reasons ailments, treat the child with antiseptics, wash the eyes with tea leaves, and so on. This gives relief - however, temporary. Then the inflammation of the eyes returns.

First you need to free the eye of the crumbs from the accumulated stagnant secretions and pus, if any. To do this, take cotton pads or make tampons. Each eye has its own tampon or disk; treatment with one disk of both eyes is strictly prohibited.

The treatment solution must be antiseptic. Decoction has these properties chamomile, furatsilina solution (weak, at a concentration of not more than 1:5000). Careful movements with a moistened swab should clear the eye of secretions (towards the bridge of the nose, from the outer edge to the inner).

Once the eye is cleansed, you can gently proceed to massage manipulations. For this, Komarovsky advises index finger feel for a tubercle located in the inner corner of the eye, at the junction with the bridge of the nose. This is the lacrimal sac. The finger should be slightly shifted above this point and make 8-10 movements down, towards the nose, along the anatomical path of the lacrimal canal itself. Do not pause between movements, let them follow one after another.

On the lacrimal sac itself, Komarovsky advises to press lightly with vibrating movements and only then lower the finger down.

One more nuance: all movements should be directed strictly from top to bottom, and the last (tenth) - in the opposite direction.

At the first movements, pus may appear, which has accumulated in the lacrimal canal. If this happens, you should stop and remove the pus in the manner described above using an antiseptic. Then you can continue the massage procedure.

The procedure can be repeated 5-7 times during the day. In the acute stage of the disease, the massage course lasts at least 14 days. With recurrent inflammation of the eyes, massage can be made a permanent procedure and done to the child daily (1-2 times).

You will learn how to massage the lacrimal canal for newborns from the following video.

Do not self-medicate. The choice of drops or ointments in the eyes with antibiotics is up to the doctor. It is advisable to pre-test for bacterial culture to find a drug that works against specific bacteria that cause inflammatory process just your child. The frequency of instillation is also determined by the doctor. Do not drip drugs after each massage, because there can be up to 8 procedures per day.

If the massage technique remains unclear or there are doubts, the mother can always contact an ophthalmologist at the clinic, who will show her how to carry out the procedure.

For tampons and discs, you should not use a medical bandage and cotton wool. These materials contain small fibers that can get into the eyes and aggravate inflammation.

If there is no severe suppuration, Komarovsky advises starting the massage with a light warm compress on the eyes. So the effectiveness of the procedure will be significantly higher.

You will learn the opinion of Dr. Komarovsky about the massage of the lacrimal canal in newborns from the following video.

Five percent of newborns are diagnosed with a blocked tear duct. I immediately want to reassure impressionable mothers and say that if your newborn child has a clogged tear duct, then you should not panic. Although this disease is not very common, it is not dangerous, especially if you seek medical help in time.

Today we will talk about methods of dealing with this disease, you will learn what probing is and how effective it is.

Obstruction of the lacrimal otter in infants (dacryocystitis) is associated with adhesions that are located inside this canal. Some experts argue that the cause of dacryocystitis is the remnants of tissue that covered and protected the eyes of the fetus during fetal development. After birth, part of this tissue remains in a special channel and interferes with the normal outflow of fluid.

The lacrimal glands are located above the eyes of a newborn baby and are hidden under the eyelids. They perform very important function, the function of moisturizing the eyes, because tears are not only a manifestation of emotions, they are also the protection of our vision. With each blink, the eyes of a newborn are wetted with a tear, this is important for nourishing and moisturizing the cornea. Tears also contain antibacterial substances that protect the eyes from various harmful microorganisms.

When a tear washes the eye, its remnants accumulate in the lacrimal sac, and then exit through a special channel that begins at the base of the eye near the bridge of the nose. Through this channel, the tears of the newborn flow into the nasal cavity. Many have noticed that while crying, children, and adults too, sniffle. This clearly shows the mechanism of lacrimation. With a blockage of the tubule intended for the outflow of fluid, the tears of the baby cannot make their natural way. In this case, there is stagnation of fluid in the lacrimal sac and souring of the eye of the newborn baby.

Signs of dacryocystitis

Dacryocystitis in its symptoms is similar to conjunctivitis. The eyes of a newborn child become inflamed, the eyelid turns red, and souring occurs in the area of the lacrimal sac. You may also notice profuse tearing and stuck together cilia in the morning. Because an obstruction cannot be diagnosed on a routine examination, most doctors treat conjunctivitis. And only after the treatment did not help, or the problem began to manifest itself too often, they make a diagnosis - dacryocystitis. This problem can be both bilateral and unilateral, but most often in newborn babies, one eye suffers.

To diagnose this problem, the pediatrician can do a collar head test. Collargol is a special coloring matter that is absolutely safe for children's vision. A few drops of this substance are dripped into the baby's eyes, and a tampon is inserted into the nose. After a certain time, a little collargol should appear on a cotton swab. This means that the baby's body performs its tear-producing function. If the swab remains clean, then the diagnosis of dacryocystitis is confirmed.

Remember that this test should only be done by a qualified doctor, do not do it yourself. To exclude such temporary causes of obstruction as a runny nose, canal swelling or other problems, you need to consult an otorhinolaryngologist.

Treatment methods for dacryocystitis in newborns

Massage

as a safe and painless treatment doctors can prescribe massage, this method is quite effective. Its specificity lies in the fact that when massaging the channel through which the outflow of fluid occurs, a lot of pressure is applied to it and the adhesion bursts. Then the liquid can freely stand out in a natural way.

Massage should be done in compliance with certain rules:

Before the massage procedure, wash your hands thoroughly and cut your nails so as not to injure the newborn baby.
Cleanse the eyes of the baby from pus. It is most convenient to do this with a cotton swab dipped in a light solution of furacilin, water infusion chamomile or warm boiled water. The use of gauze swabs is undesirable, they leave villi.

Perform the massage with jerky movements, moving the pad of your finger from the lacrimal sac to the baby's nose. These movements should be repeated 5-10 times without a break.

If pus is released when pressing on the corner of the eye, remove it with a clean swab and continue to massage.
If your doctor has prescribed eye drops, bury them at the end of the procedure.

sounding

When massaging did not help, then there is a chance that by a certain age this problem will disappear by itself. If the baby grows, and the dacryocystitis does not go away, then the doctor prescribes more radical method- probing.

This procedure is performed under local anesthesia. The essence of probing the lacrimal canal in infants is that a probe is inserted into this canal, which breaks the adhesion and clears the way for natural tearing. After probing, the doctor may advise the mother of a newborn baby to massage the area from the eye to the nose and drip special drops into the eyes. They need to be dripped into both eyes, even if one of them is healthy. This is necessary so that the infection does not spread to him.

But even after this manipulation, adhesions can form again. In this case, a new probing is performed, it is repeated one and a half to two months after the previous operation.

If the probing method turned out to be ineffective, then perhaps the baby has another pathology of the nasopharynx, which should be diagnosed pediatric ophthalmologist and sometimes an otolaryngologist.

Prevention of obstruction in newborns

Caring parents who are worried about the health of their newborn child want to know how to protect themselves from this disease. The fact is that such obstruction is a congenital problem, so it cannot be prevented. Therefore, as a preventive measure, pediatricians recommend diagnosing this disease in time.

Timely treatment, such as massage or probing, will help get rid of minor annoyances associated with the disease, as well as save your newborn baby from possible complications which are treated only with the help of surgery.

Video: how to massage the lacrimal canal

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Girls, tell us, have your newborn baby been diagnosed with an obstruction of the lacrimal canal? Leave your comments and write in them which treatment method helped you. Did you have to do probing to your baby? How effective do you think this method is?