tear duct obstruction
Introduction
Introduction Obstruction of the lacrimal duct is a disease that often occurs in the punctum, the lacrimal canal, the junction of the lacrimal sac and the nasolacrimal duct, and the lower nasolacrimal duct, with tears as the main symptom. The lower end of the nasolacrimal duct is an anatomical stenosis segment that is susceptible to obstruction by nasal lesions. The beginning of the lacrimal duct (puncture, lacrimal canal, and lacrimal duct) has a narrow diameter, a shallow surface, and is adjacent to the conjunctival sac, which is easily blocked by inflammation and trauma. Under normal circumstances, tears flow through the surface of the eyeball and then exit through the two small openings (tears) inside the eyelid. The lacrimal passage is connected to the nasal lacrimal passage, and the nasal lacrimal passage is opened under the nasal passage. The tears flow through the nasal lacrimal passage. If the lacrimal passage is narrow and the nasal lacrimal duct is blocked, the tears will spill over to the cheeks. The lacrimal duct obstruction is divided into complete obstruction and incomplete obstruction. For the examination, just insert a probe from the inside of the orbital opening of the eyelid and inject saline to see if the saline enters the throat through the nasal cavity. If the lacrimal duct is blocked, the salt water will not pass. Aunt Chen often shed tears, which is caused by obstruction of the right nasal lacrimal duct.
Cause
Cause
1. The position of the eyelids and punctum is abnormal, and the punctum cannot contact the tear lake.
2, abnormal punctum, including narrow punctum, occlusion or lack of, tears can not enter the lacrimal duct.
3, the obstruction or stenosis of the lacrimal canal to the nasolacrimal duct, including congenital atresia, inflammation, tumor, stone, trauma, foreign body, drug toxicity and other causes of lacrimal duct structure or insufficiency, resulting in tears can not be discharged.
4, other reasons, such as nasal obstruction.
Examine
an examination
Related inspection
Lacrimal examination blood routine
Interruption or stenosis of the organic lacrimal duct can occur anywhere in the lacrimal duct, and determining the obstruction site is important for the choice of treatment regimen. Commonly used inspection methods are:
Lacrimal lavage test: A method of connecting a flushing needle with a syringe containing saline, injecting physiological saline from the punctum into the lacrimal canal, and judging the obstruction or stenosis of the lacrimal passage according to the discharge of the liquid.
1. The flushing fluid is injected into the nasopharynx from the lower punctum, and part of the fluid is stenosis from the upper punctum.
2. The rinsing solution is completely returned from the upper punctum to the end of the lacrimal duct or the nasolacrimal duct obstruction. If a large amount of mucous secretions are flushed out, the nasolacrimal duct obstructs chronic dacryocystitis.
3. The rinsing liquid is all returned from the lower punctum. When the rinsing is high, the resistance should be flushed from the upper tears. If the lacrimal passage is smooth, the lower tear duct is blocked, and the puncture is flushed from the original small tears. Then the tears are blocked.
4. The eyelids are swollen during rinsing, neither returning from the punctum, nasal cavity, or liquid in the mouth, indicating that the irrigation needle enters the surrounding subcutaneous tissue, should immediately stop the flushing, and give antibiotics to prevent infection.
Accurate identification of the obstruction site can be done by injecting lipiodol into the iodized oil and making an X-ray photograph.
Diagnosis
Differential diagnosis
Occial duct obstruction will be secondary to dacryocystitis, acute dacryocystitis can be used hot, and antibiotics are used under the guidance of a doctor. In patients with chronic dacryocystitis, the nasolacrimal duct can be dilated with a probe under local anesthesia. In addition, patients with nasal and paranasal sinuses should be actively treated to avoid nasal septum deviation, hypertrophic rhinitis, mucosal polyps, and inferior turbinate hypertrophy. The nasolacrimal duct is blocked by the congenital membrane tissue at the lower end of the nasal nasolacrimal duct. The membrane tissue is still not broken after about 4 weeks of birth.
