Inflammation of the lacrimal gland is otherwise called dacryoadenitis. This disease can be caused by both mechanical and toxic irritation of the mucous membrane of the lacrimal sac and lacrimal ducts. There are acute and chronic forms.
The structure of the lacrimal organs
The named organs belong to the adnexa of the eye. They include the lacrimal glands and lacrimal ducts. The part of the gland that is located in the orbit appears in the embryo at the age of eight weeks. However, even after thirty-two weeks of development, after birth, the lacrimal fluid in the newborn is not yet released, since the gland remains underdeveloped. And only after two months babies start crying. Interestingly, the tear ducts form even earlier, at the sixth week of the gestational period.
The lacrimal gland consists of two parts: orbital and secular. The orbital part is located in the recess of the frontal bone on the upper lateral wall of the orbit. The second part of the gland is much smaller than the first. It is located below, under the arch of the conjunctiva. The parts are connected by excretory tubules. Histologically, the lacrimal gland resembles the parotid gland. The blood supply comes from the ophthalmic artery, and the innervation comes from two of the three branches of the trigeminal nerve, the facial nerve and sympathetic fibers from the cervical plexus. Electronic impulses are sent to the medulla oblongata, where the tear center is located.
There is also a separate anatomical apparatus for removing tears. It begins with a lacrimal stream located between the lower eyelid and the eyeball. This "stream" flows into the lacrimal lake, with which the upper and lower lacrimal points are in contact. Nearby, in the thickness of the frontal bone, is the sac of the same name, which communicates with the nasolacrimal canal.
Functions of the lacrimal apparatus
The fluid secreted by the eye is essential for moisturizing the conjunctiva and cornea. The refractive power of the cornea, its transparency, smoothness and brilliance are to some extent dependent on the layer of tear fluid that covers its front surface.
In addition, on the left it performs a nutritional function, since the cornea has no blood vessels. Due to the fact that moisture is constantly updated, the eye is protected from foreign objects, dust and dirt particles.
One of the important features of tears is the expression of emotions. A person cries not only from grief or pain, but also from joy.
Composition of tears
The chemical composition of a tear is similar to blood plasma, but it has a high concentration of potassium and chlorine, and there are much less organic acids in it. An interesting fact is that, depending on the state of the body, the composition of the tear can also change, so it can be used todiagnostics of diseases, on a par with a blood test.
In addition to inorganic compounds, tears contain carbohydrates and proteins. They are covered with a fatty membrane, which does not allow them to linger on the epidermis. There are also enzymes in the lacrimal fluid, such as lysozyme, which has an antibacterial effect. And, oddly enough, crying brings relief not only because of moral catharsis, but also because tears contain psychotropic substances that suppress anxiety.
During the time that a person spends without sleep, about a milliliter of tears are released, and when crying, this amount increases to thirty milliliters.
Lacrimal mechanism
Tear fluid is produced in the gland of the same name. Then, along the excretory tubules, it moves to the conjunctival sac, where it accumulates for some time. Blinking transfers the tear to the cornea, wetting it.
The outflow of fluid is carried out through the lacrimal stream (narrow space between the cornea and the lower eyelid), which flows into the lacrimal lake (inner corner of the eye). From there, through the channel, the secret enters the lacrimal sac and is evacuated through the upper nasal passage.
Normal tearing is based on several factors:
- sucking function of lacrimal openings;
- the work of the circular muscle of the eye, as well as Horner's muscles, which create negative pressure in the ducts that drain the tear;
- presence of folds on the mucosa that act as valves.
Lacrimal gland examination
The eyelid part of the gland can be felt during the examination, or the upper eyelid can be turned out and examined visually.
Examination of the function of the gland and the lacrimal apparatus begins with a canalicular test. With its help, the suction function of the lacrimal openings, sac and tubules is checked. They also conduct a nasal test in order to find out the patency of the nasolacrimal canal. As a rule, one study leads to another.
If the lacrimal apparatus is in order, then one drop of 3% collargol, instilled into the conjunctiva, is absorbed within five minutes and exits through the nasolacrimal canal. This confirms the staining of a cotton swab located in the lower nasal passage. In this case, the sample is considered positive.
Passive patency is checked by probing the lacrimal ducts. To do this, Bowman's probe is passed through the nasolacrimal canal, and then, by injecting fluid into the upper and lower lacrimal puncta, its outflow is observed.
Causes of inflammation
In ophthalmology, inflammation of the lacrimal gland is quite common. The causes of the pathology can be very different - both general diseases such as mononucleosis, mumps, influenza, tonsillitis and other infections, as well as local pollution or suppuration near the lacrimal duct. The route of infection is usually hematogenous.
Inflammation of the lacrimal gland can have both acute and chronic course, when light intervals alternate with relapses. A permanent form may occur due to oncological diseases, withtuberculosis or syphilis.
Symptoms
Why should you not start inflammation of the lacrimal gland? Photos of patients with this pathology show that it is not so easy to ignore these symptoms. And only a person who is indifferent to his he alth can allow the development of complications.
At the very beginning, inflammation of the lacrimal gland is manifested by pain in the inner corner of the eye. Local swelling and redness are clearly visible. The doctor may ask the patient to look at their nose and, by lifting the upper eyelid, see a small section of the gland. In addition to local, there are general signs that characterize inflammation of the lacrimal gland. The symptoms are similar to those of other infectious diseases: fever, headache, nausea, fatigue, swollen lymph nodes in the head and neck.
Patients may complain of double vision, blurry vision, or problems opening the upper eyelid. With a strong reaction, the entire half of the face swells, with the affected eye. If the symptoms are left unattended, then, in the end, the situation may worsen into a phlegmon or abscess.
Inflammation of the lacrimal gland in a child proceeds in the same way as in an adult. The only difference is that the chance of spreading the infection is higher than in adults. Therefore, the treatment of children is carried out in a hospital.
Topical treatment
On average, the whole process from the onset of inflammation to its resolution takes about two weeks, but if you see a doctor in time, you cansignificantly reduce this time. An experienced specialist will quickly determine the inflammation of the lacrimal gland. Treatment, as a rule, is prescribed complex. Indeed, as already indicated in the causes of the disease, most often it is only a consequence of another infection.
Therapy begins with antibiotics in the form of drops or ointments, such as Ciprofloxacin, Moxifloxacin or tetracycline solution. You can attach glucocorticoids, also in the form of drops. They relieve inflammation of the lacrimal gland. After the acute period has passed, the patient is sent to the physiotherapy room for ultraviolet heating.
If an abscess has formed at the site of inflammation, then it is opened and drained through the nasolacrimal canal.
General treatment
Sometimes local measures are not enough to cure the disease, in addition, it is necessary to prevent the spread of infection throughout the body. For this, antibiotics of the cephalosporin or fluoroquinolone series are used, which are administered parenterally. General symptoms of inflammation respond well to systemic glucocorticoids.
Usually these measures are enough to cure the inflammation of the lacrimal gland. Symptoms, treatment and prevention of this disease do not constitute significant difficulties for an ophthalmologist. The main thing is that the patient seeks help in time.
