Treatment of nasolacrimal duct obstruction

Human lachrymals consist of lacrimal apparatus (lacrimal gland and attached tear glands) and lacrimal passages (tear runlet, lacrimal lake, lacrimal points, lacrimal ducts, lacrimal sac and nasolacrimal duct).

Lacrimal passages pathology is a separate line of ophthalmology. This pathology is diagnosed in 25 percent of patients with eye diseases.

This group of diseases has several claims but one of them is the most typical – watery eye.

Under normal conditions human lacrimal gland releases 10-14 tear-drops per calendar day. At the time of lacrimal reflex – eye contact with foreign body, in the wind, in emotional state – tear out put increases sharply.

Why is continuous lacrimation unpleasant?

Such diseases cause never-ending lacrimation which is painful and unpleasant. Non-stop running tears create cosmetic problems. Excessive tears damage eye cosmetic beauty. In addition, stagnant tear and mucin are breeding ground for bacterial growth resulting in inflammation of lacrimal passages and aggravated risk of purulent keratoconjunctivitises progression with serious complications.

Why does lacrimation appear?

The reasons of lacrimation disorder can be both congenital and acquired anomalies – results of traumas, chronic inflammations and unskilled medical manoeuvres in the course of detersion and intubation.

All lacrimation disorders can be divided into two groups:

  • partial obstruction of the lacrimal system (dacryostenosis);
  • its absolute obstruction (obliteration).

Diagnostics and treatment of nasolacrimal duct obstruction is a rather pressing problem in dacryology. It is associated with a small diameter of the lumen of lacrimal passages (0.25-0.5 mm), existence of valvular folds of the ocular mucosa, hyper normal tendency towards cicatrization and coalescence, while reconstruction efficiency in case of a disease remains very low.

For the purpose of this pathology diagnostics the ophthalmological clinic SVIT ZORU offers:

  1. Simple examination and palpation;
  2. Schirmer’s test, runlet test, tubular and nasal test;
  3. Irrigation of lacrimal ducts;
  4. Intubation of lacrimal ducts;
  5. Intubation of nasolacrimal duct.

After examination an ophthalmologist will choose correct treatment option depending on proven diagnosis. Eye physician’s arsenal includes both rather simple methods, such as detersion, bougienage, intubation, temporary intubation with polymeric materials, and more complicated ones – plastic operations on lacrimal points, ducts and sac (dacryocystorhinostomy, prosthetics lacrimal).

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