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Neonatal dacryocystitis
Last reviewed: 04.07.2025
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[ What causes dacryocystitis in newborns?
The main reason for the development of dacryocystitis in newborns is that at the time of birth the nasal opening of the nasolacrimal duct does not open (due to a developmental defect), which in these cases ends in a blind sac.
In children, diseases of the lacrimal ducts are often the cause of chronic conjunctivitis, phlegmon of the lacrimal sac and orbit, corneal lesions, septicopyemia, etc. Untreated dacryocystitis gradually leads to irreversible anatomical changes in the lacrimal ducts, which over time exclude the success of conservative treatment.
Symptoms of Dacryocystitis in a Newborn Baby
A few days after birth, a slight discharge of mucopurulent contents from the conjunctival sac appears. The conjunctiva of the eyelids is hyperemic. When pressing on the area of the lacrimal sac, its contents are released from the lacrimal points. Dacryocystitis of the newborn can lead to the development of real dacryocystitis with the release of purulent contents, but more often the disease ends well, since the membrane that closes the exit from the lacrimal ducts is restored.
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Treatment of dacryocystitis in newborns
Treatment of dacryocystitis in newborns is recommended to begin with vigorous massage of the lacrimal sac from the outside at the inner corner of the eye slit from top to bottom. From the push-like pressure on the contents of the lacrimal sac, the membrane that closes the exit from the nasolacrimal duct ruptures, and the patency of the lacrimal ducts is restored.
To prevent infection of the contents of the lacrimal sac, it is recommended to instill a 20% solution of albucid or penicillin into the joint sac.
If massage for dacryocystitis in newborns has no positive effect, endonasal retrograde probing is used, which should be started at the age of two months. Without preliminary anesthesia, under visual control, a surgical button probe, bent at the end at a right angle, is inserted along the bottom of the nasal cavity to half the length of the inferior nasal passage. When removing the button probe, the bent end of the probe is pressed tightly to the vault of the inferior nasal passage and the obstruction at the mouth of the nasolacrimal duct is perforated, then the probe is removed. After probing, the lacrimal ducts are washed with an antibiotic solution. This accelerates the process of restoring normal lacrimation. If there is no effect, repeated probing is carried out at intervals of 5-7 days. Three-time probing is justified up to the age of 6 months. The lack of effect from retrograde probing forces us to switch to treatment by external probing with a Bowman probe No. 0 or No. 1. After dilating the lacrimal point with a conical probe, the Bowman probe is inserted horizontally along the canal into the sac, then it is moved to a vertical position and advanced down the nasolacrimal duct, perforating the membrane that has not been absorbed by the time of birth in its lower part. If there is no effect from this treatment, dacryocystorhinostomy is performed on children over 2 years of age.