Tears are caused by eye inflammation, foreign body stimulation, emotional impulse, etc. Dysfunction of any part of lacrimal passage will lead to tears overflow.
The cause of disease
(1) Abnormal lacrimal punctum: When the lacrimal punctum is everted, narrow, occluded or absent, tears cannot flow into the lacrimal passage.
(2) Abnormal lacrimal passage: Dysplasia (congenital atresia), trauma, foreign body, inflammation, tumor, scar contraction or nasal diseases can all cause lacrimal passage stenosis or obstruction, and can all cause lacrimal overflow.
clinical picture
Long-term tears overflow, the skin around the inner canthus is flushed and rough, and eczema appears. The lower eyelid can be everted because it is constantly wiped down.
diagnose
(1) test method for fluorescein liquid
(2) Lacrimal irrigation
Analysis of lacrimal passage irrigation results.
1, normal people have no resistance when injecting irrigation solution, and irrigation solution flows into nasal cavity or pharynx smoothly.
2. There is resistance when the irrigation solution is injected, and some of it flows back from the lacrimal punctum and some of it flows into the nasal cavity, which is nasolacrimal duct stenosis.
3. When the irrigation solution completely returns from the original injection route, the lacrimal canaliculus is blocked.
4. The irrigation fluid is injected from the inferior lacrimal punctum and refluxed from the superior lacrimal punctum, which is the common lacrimal canaliculus obstruction.
5. The irrigation fluid flows back from the lacrimal punctum, and at the same time, mucus or mucus purulent secretion flows out, which is nasolacrimal duct obstruction and complicated with chronic dacryocystitis.
(3) X-ray lipiodol radiography can be performed when necessary. The lacrimal duct obstruction and the size of lacrimal sac can be known by injecting contrast agent through lacrimal canaliculus with a lacrimal sac irrigation needle and immediately taking anteroposterior and lateral photos. Acute dacryocystitis is rare in clinic, mostly occurring in children or young people. Most of them are unilateral diseases, and inflammation can be confined to eyelids or orbital lacrimal glands, or all of them can be involved.
The treatment of lacrimal gland diseases is taking sulfanilamide preparation or antibiotics and hot compress. Incision and discharge as soon as possible after suppuration.
Chronic dacryocystitis, chronic dacryocystitis is characterized by chronic congestion and simple hypertrophy of lacrimal gland, generally no pain, but mild swelling with ptosis. When the eyeball is pushed under the nose, the activity is limited and diplopia occurs, but exophthalmos rarely occurs.
Treatment should be directed at the cause. Because of the difficulty in diagnosis, lacrimal gland is often removed for pathological examination. 1. Laser treatment of lacrimal passage: It has the advantages of less trauma, no side effect, no scar, short operation time and economy, and is the first choice for some patients with lacrimal passage diseases. It is mainly used to treat lacrimal duct stenosis and obstruction caused by inflammation, such as lacrimal canaliculus and common lacrimal duct stenosis and obstruction, nasolacrimal duct obstruction, chronic dacryocystitis and other cases.
2. Lacrimal canal surgery: including lacrimal punctoplasty, probing of lacrimal passage, repair of lacrimal fistula, repair of lacrimal canaliculus obstruction, repair of traumatic lacrimal canaliculus rupture, repair of lacrimal canaliculus obstruction, dacryocystorhinostomy, total lacrimal canaliculoplasty, etc. Suitable for lacrimal punctum stenosis, congenital dacryocystitis, traumatic lacrimal canaliculus rupture, chronic dacryocystitis and other cases.
In fact, at present, the commonly used methods to treat lacrimal duct obstruction include probing, intubation, threading, high-frequency electricity and other non-surgical treatments, dacryocystectomy, dacryocystostomy, laser and so on. Among them, laser treatment of lacrimal duct obstruction can reduce the tissue damage of patients to a certain extent without destroying the normal lacrimal duct structure.