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Obstruction of Lacrimal Ducts

Obstruction of Lacrimal Ducts

Dr. Yusuf Avni Yilmaz, ophthalmologist at Anadolu Medical Center

Obstruction of lacrimal ducts is observed in approximately 5% of the newborns.


The lacrimal system structures begin their formation in the fifth week of the pregnancy, and the lacrimal or tear duct is formed in the eighth gestation week. This development continues all over the pregnancy. Tears are formed in the lacrimal gland, fill in the sac and flow into the nasal cavity through the tear duct. The contraction of eyelid muscles acts like a pump for the drain of the tears in the nasal cavity. The obstruction in any part of this system leads to lacrimation of the eyes. 

Complaints begin a couple of weeks after birth. Such blockage observed in newborns, may occur at any point of the tear drainage system, from the puncta (openings in the corners of the eyelids) to the nose. Often, the first indication are the watery eyes.  If not attended on time, a concomitant symptom may be the occurrence of a yellow discharge, known as rheum or purulence.

Condition diagnosis

Diagnosing begins following thorough examination. The nature of the lacrimation and the existence of other concomitant symptoms give the doctor grounds to build an opinion. Additional tests of the baby may be performed such as measuring intraocular pressure, measuring the corneal diameter and visualization of tear ducts, which are carried out under anesthesia.

Though the most common cause for the watery eyes of babies is the obstruction of the tear ducts, there might be other reasons as well. The most important of them is the congenital glaucoma.  This should be taken into consideration in a differential diagnosis. Congenital glaucoma is a much more serious disease than the obstruction of tear ducts. Tumors and cysts, as well as common congenital defects which are obstructing the duct should also be considered.

Treatment of obstructed tear ducts

The applied treatment must be reason dependent. As the reason is usually congenital stenosis or duct obstruction, this requires the treatment to be regarded in two options. Firstly, a non-invasive treatment is recommended, the primary component in this treatment being the massage, applied on the lacrimal sac in order to increase pressure. With a suitable massage most of the cases are managed until the age of 1. In addition to the massage, if lacrimation turns into a yellow discharge, a further treatment has to be applied considering the possibility of infection.

If the problem persists, regardless of the massage, there are various treatment methods to be applied, from medications to surgery.

The second treatment option is examination of the tear ducts if the infant, though less than a year of age, has an uncontrollable infection of the lacrimal ducts. The procedure is performed under general anesthesia, and because it is a short one, there is no need to sedate the baby for long time. The process gives significant results.

The treatment of watery eyes, other than the simple obstruction of the duct, is completely focused on the cause. Congenital glaucoma is a severe condition, that needs priority attention. In this case, case there is a wide range of treatment methods comprising medications and surgical intervention. When tumors, cysts, etc. are detected which block the tear drainage system, the treatment, again should be cause-oriented.

Do not postpone the treatment

When a duct is blocked, a delay in treatment may lead to the development of complications due to frequent infections. Furthermore, the successful outcome decreases when the child becomes elder than 12-15 months. If, in the event of early diagnosis the problem may be resolved with a simple intervention, such as probing, an elderly age may require more complex operations. The delayed congenital glaucoma diagnosis may lead to severe and permanent vision loss.

The doctors at the ophthalmological department of Anadolu Medical Center are highly experiences which allows for the management of complex and advanced disease stages, regardless of the severity of the case. The department is furnished with the most modern equipment for diagnosis and treatment and doctors combine both conservative and modern treatment approaches with respect to highest efficiency.

 

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