Probing the lacrimal canal in newborns is a major ophthalmic operation during which the gelatin film is removed. She does not let the tears that appear in her eyes into the nasal cavity. Usually this channel opens on its own with the first breath and cry of the child. However, 5% of newborns have a pathology.
Medical certificate
Every baby has a gelatin film covering their eyes, airways and nose during their intrauterine life. It prevents amniotic fluid from entering and usually bursts at birth. If this process does not occur, a plug forms in the lacrimal canal. It interferes with the process of tearing. The released secret does not enter the nasal canal and accumulates in the lacrimal sac. As a result, the latter can become inflamed and deformed. Reproduction in this area of bacteria leads to the formation of purulent masses, and a swelling forms near the eye itself. These phenomena are known in medicine as the disease dacryocystitis.
Pathology can be caused by a congenital curvature of the nasal septum. This is the main, but not the only reason for blockage of the lacrimal canal by secreted secretions and dead epithelial cells. Dacryocystitis is manifested by the following symptoms:
- flow of tears from the eye;
- presence of purulent discharge;
- puffiness of the eyelids;
- swelling in the eye area.
After confirming the diagnosis, the doctor prescribes treatment. In the early stages of pathology, it comes down to massage and the use of anti-inflammatory drops. In the absence of positive dynamics, probing of the lacrimal canal is recommended. The operation is scheduled at the age of 6 months. Early treatment provides a positive effect in 85-95% of cases. After a year, the film begins to harden, which significantly complicates the therapy. In older children, recurrence is common and requires re-intervention.
Causes of obstruction of the tear duct
Dacryocystitis is not the only reason for the development of the disorder. Among the main factors provoking blockage of the lacrimal sac, doctors identify:
- hereditary disorders transmitted at the gene level;
- injury and mechanical damage;
- sinusitis, blepharitis, tuberculosis;
- obstruction due to syphilis.
If you do not see a doctor in a timely manner, purulent discharge can spread to the second eye, infect the ear. In addition, refusing surgery often results in reduced or complete loss of vision.
Preparing for the procedure
Surgery is usually reserved for infants aged 1 to 4 months. Probing the lacrimal canal in newborns is no different from that procedure for schoolchildren or adolescents. Before the intervention, it is necessary to show the child to an otolaryngologist. The specialist must exclude the curvature of the nasal septum. Otherwise, the effect of the procedure will not live up to expectations.
In addition, preparatory activities include:
- Checking blood for clotting.
- Lacrimal sac secretion analysis.
- Examination by a pediatrician for associated he alth problems.
- A consultation with an allergist to minimize the risk of an allergic reaction to the anesthesia used.
- Vest test. During the procedure, a colored liquid is instilled into the child's eye, and a swab is inserted into the nasal cavity. How severely blocked the channel is, shows the amount of fluid on the tampon.
A newborn should not be fed a few hours before surgery. It is also recommended to swaddle the baby tightly to prevent movement during the procedure. Before probing, it is strictly forbidden to take medications that are incompatible with the drugs that doctors will use.
Steps of the operation
Probing of the lacrimal canal in newborns is carried out in a hospital. The procedure itself lasts no more than 10 minutes, hospitalization after it is not required. It is performed using local anesthesia. As an anestheticusually use "Alkain". The operation consists of the following steps:
- The patient is laid on the couch and an anesthetic is instilled into the eyes.
- Fix the position, the nurse holds the head.
- A special probe is inserted into the lacrimal canal of a newborn to help expand the ducts.
- Additional assistance from a thinner probe may be required to break through the gelatin film.
- The ducts are flushed with disinfectant.
- At the final stage, the West test is repeated.
A few hours after the end of the procedure, parents can take the little patient home. If a serious infectious lesion is detected, the baby is left in the hospital for several days until the final recovery.
Recovery period
In order to avoid complications after probing, it is necessary to use antibiotic drops for some time. The name, dosage and duration of use is determined by the doctor. Within a week after the operation, it is also recommended to massage the lacrimal canal. The stages of its implementation should be told by the doctor at the consultation.
All week after the intervention, there may be slight bleeding from the nose, its congestion. These are quite normal phenomena and are not a reason for panic. Inflammation and tearing should disappear on their own in about 10-15 days. The child is allowed to bathe daily, and you should not forbid him to rub his eyes. If eye discomfort persistsmore than two weeks, additional symptoms of malaise appear, it is necessary to consult a doctor. Only in this case can the development of related he alth problems be prevented.
Possible Complications
Probing the tear duct is a fairly simple procedure. However, it implies an intervention, so sometimes it is not possible to avoid complications. Moreover, each organism is individual and can react to the operation in its own way.
As a rule, complications arise due to a violation of the probing technique. A scar may form at the site where the tear duct was originally punctured. Among other complications doctors mention the following:
- lacrimation;
- irritation of the mucous membrane of the eyelid and the development of conjunctivitis;
- redness of the eyeball;
- discharge of purulent or cloudy secretion from under the eyelids;
- fever, chills;
- appearance of adhesive process in the lacrimal canal;
- the child becomes lethargic and moody, may refuse to eat.
How do children react to anesthesia? According to statistics, every tenth patient has nausea and vomiting within 10 days after surgery. Only 1% of children have an allergic reaction to anesthesia.
Risks and Forecasts
Many parents quite often confuse the obstruction of the lacrimal duct and conjunctivitis. Both pathologies have a similar clinical picture. At the same time, improper treatment beginsconjunctivitis, which relieves symptoms only for a short time. The cause of the underlying disease is not eliminated.
The consequences of this kind of therapy are expressed in the accumulation of purulent masses, the deterioration of the child's well-being. Then the clinical picture is complemented by severe swelling and the appearance of a seal. In a small patient, the temperature rises, he becomes restless and capricious. Only an appeal to an ophthalmologist can correct the situation, determine the need for surgical intervention.
A distinctive feature of dacryocystitis is the discharge of pus from one or both eyes at the same time. When massage of the lacrimal duct does not bring relief, surgery is necessary. An indication for probing is also considered a narrowing of the lacrimal duct, the presence of chronic inflammation in this area, and profuse lacrimation. As a rule, the procedure has a favorable prognosis, small patients recover quickly.
Need for re-intervention
To restore the patency of the lacrimal ducts in newborns, one probing procedure is enough. However, neglecting the doctor's recommendations in the postoperative period can provoke a relapse. This phenomenon is often accompanied by adhesions. Also, a second intervention is recommended if after the first one there is no improvement in the condition of a small patient within 30 days.
The second procedure for probing the lacrimal canal in children is practically the same as the first. It is carried out according to the same principle. ATIn some cases, the doctor decides to insert special silicone tubes into the ducts. They prevent clogging of the tear ducts. The tubes are removed after about six months. The care of the child all this time is carried out according to the same scheme as after the standard operation.
Alternative sounding options
Can surgery be avoided? The only alternative probing option is to massage the lacrimal ducts in newborns. The purpose of this procedure is to break the gelatinous film, which provokes blockage. A pediatrician should tell you more about it. Before carrying out manipulations, you need to wash your hands thoroughly so as not to infect the child's eyes.
The technique of lacrimal canal massage in newborns comes down to the following rules:
- First you need to wipe the baby's eyes with a cotton swab dipped in a solution of "Furacilin". To do this, one tablet of the product must be dissolved in 100 ml of warm water. It is important to use a new swab for each eye, and it is better to wipe from the outer edge to the inner.
- Gently press on the area above the lacrimal duct and slide your fingers to the base of the nose.
- Repeat about 10 times.
- Discharges that appear during the procedure should be carefully removed with a clean cotton swab.
- At the final stage, it is recommended to drop anti-inflammatory drugs into the child's eyes.
This massage is recommended by doctors during feeding. Per day procedure is recommendedrepeat up to 6 times over two weeks. If after this period the symptoms of dacryocystitis do not disappear, you will have to do probing of the lacrimal ducts.
It is worth noting that it is not worth resorting to folk methods of treating pathology. The visual apparatus of the child is not yet well developed, and the skin around the eyes is very sensitive. The use of alternative medicine recipes can only aggravate the situation, negatively affect the well-being of the newborn.
Parent reviews
Unfortunately, many parents try to treat dacryocystitis on their own, guided by the advice of relatives or friends. This approach is highly undesirable. The progression of the disease and the lack of competent therapy can only aggravate the situation. If at the initial stage it is possible to stop the manifestations of the pathology through massage, then with advanced forms one can no longer do without the help of probing the lacrimal canals.
Adults have their own opinion about this procedure. Most of them are positive about it. Indeed, sounding is a fairly simple procedure that allows you to cope with the blockage of the lacrimal sacs. It takes only a few minutes for an experienced specialist to carry it out, and the result justifies the time spent. After a few days, the positive effect of the intervention becomes noticeable.
Negative opinions do not bypass the probing of the lacrimal canals of the eyes. However, for the most part, they are associated with the process of preparing a newborn for the procedure. A few hours before it is necessary not to feed the baby. If an older childcan explain such a measure, then things are much worse with breastfeeding.
The second negative point concerns swaddling. It's no secret that modern parents refuse these events. Immediately after the maternity hospital, they dress their children in their usual clothes and do not use diapers. Therefore, many babies, being "connected", begin to be frightened and scream even more. However, pediatricians offer their own solution to the current problem - to use a "sleeping bag". This product is now available in all children's stores. Being in it, the child feels absolutely comfortable, and his hands do not interfere with the doctor's manipulations.
In closing
Probing is an effective procedure. With proper implementation, the risk of complications is reduced to zero. At the same time, the probability of a favorable outcome is maximum. However, before the procedure, doctors advise trying to restore the patency of the tear duct in conservative ways, such as massage. If, despite all the suffering, the baby's eyes continue to watery, purulent discharge appears, surgery is indispensable. In the hands of an experienced specialist, the procedure does not cause significant discomfort and is well tolerated even by very young children.
