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Canaliculitis: causes, symptoms, diagnosis, treatment

 
, medical expert
Last reviewed: 21.11.2021
 
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Inflammation of the tubule (canaliculitis) often occurs secondary against the background of inflammatory processes of the eyes, conjunctiva. The skin in the tubule area becomes inflamed. There is marked lachrymation, mucopurulent discharge from lacrimal points.

Treatment of canaliculites conservative, depending on the causes.

Inflammation of the tear duct (canaliculitis) - usually chronic, often fungal. This is the most common ophthalmomycosis. Actinomycosis is more common, less often candidiasis and sporotrichosis. Primarily affects the lower lacrimal canaliculus, less often both; usually the process is one-sided. First, there is hyperemia of the lacrimal flesh and the transitional fold, lacrimation, crusts in the inner corner of the eye, then there is a swelling along the tear duct, which resembles barley. Sealing along the tubule is painless, the teardrop is widened and lagging behind the eye, a slight reversal of the eyelid is observed. With pressure on the tear duct from the tear point, a cloudy pus-like liquid is released, sometimes with grains of stones.

Later there is a blockage of the lacrimal point, a dilatation of the tubule and its perforation. Mycosis of lacrimal ducts is accompanied by persistent conjunctivitis, which is not amenable to cure, occasionally it is complicated: the cornea and tear sack are involved in the process. Fungal canal canals are treated by dilating the tubule and removing the stones, then lubricating the exposed tubule with a 1% alcoholic solution of brilliant green or a 5% solution of iodine. Be sure to examine the contents of the tubule for the presence of mycelium.

Damage to lacrimal canals is possible with trauma to the inner part of the eyelids. It is necessary timely surgical treatment, otherwise there is not only a cosmetic defect, but also lacrimation. During the initial surgical treatment, the wounds are compared with the edges of the damaged lower tear duct, for which Alexeyev's probe is guided through the lower lacrimal point and the canaliculus, the mouth of the lacrimal canals, the upper lacrimal canaliculus and its end from the upper lacrimal point.

After inserting a silicone capillary probe into the ear, the probe is removed by reverse movement, and the capillary takes its place in the lacrimal pathways. The skewed ends of the capillary are fixed with a single seam, a ring ligature is formed, and skin seams are applied to the soft tissues at the point of their rupture. Cutaneous sutures are removed after 10-15 days, the annular ligature is removed after a few weeks.

Chronic canaliculitis is a relatively infrequent pathology caused by Actinomyces (anaerobic gram-positive bacteria). For the emergence of canaliculitis there are no special predisposing factors, while diverticulum or obstruction of the tubule due to stagnation may contribute to the development of anaerobic bacterial infection.

It is manifested by one-sided lacrimation associated with chronic mucopurulent conjunctivitis, which is not susceptible to normal treatment.

Perikanalikuljarnoe an inflammation, characterized by an edema of tubules and a tearful point tearful point, well distinguishable at inspection in the light slit lamp.

Curd detachable, consisting of lumps caught during the compression of tubules with a glass rod

Unlike dacryocystitis, there is no obstruction of the nasolacrimal canal, dilatation of the lacrimal sac or inflammation.

Treatment of chronic canaliculitis

  • local antibiotics such as ciprofloxacin 4 times in laziness for 10 days, but they are not always effective;
  • canaliculotomy - linear opening of the tubule by the conjunctiva - is most effective, although in some cases it can lead to scarring and disruption of the function of the tubules.

trusted-source[1], [2], [3]

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