Childhood is a special time in the life of every person. During this period, all anatomical structures of the body actively develop: skin, bones, muscles, internal organs. Most of them undergo major changes that involve more than just growth. Many structures exist during fetal development. With some, the child is born. However, almost all of them are eliminated during the first few months of life. Otherwise, problems arise. A disorder of tear drainage into the nasal cavity is one of them. In this case, the doctor prescribes probing of the nasolacrimal duct for the child.

The mechanism of tear drainage into the nasal cavity

The lacrimal organs are an important component of the visual analyzer. The eyeball is protected from drying out by moisture, slightly different in composition from water. This fluid is produced by the lacrimal gland, hidden under the upper eyelid.

The tear that washes the eyeball needs drainage pathways. Nature has come up with an extremely ingenious solution in this regard. The fluid flows along the tear stream along the lower eyelid into the lake in the area of ​​the inner corner of the eye. From here it travels into the lacrimal sac, then down the nasolacrimal duct. Nasal congestion that occurs when crying is a direct consequence of this anatomical feature.

Tears are normally drained from the eyeball through the nasolacrimal duct.

The nasolacrimal duct is formed from the sixth week of embryonic life. It grows from the inner corner of the eye towards the nasal cavity. Sometimes the channel ends blindly. Thirty-five percent of newborns are born with a similar anatomical feature.

In most cases, an obstacle to the free outflow of fluid from the eyeball is a thin membrane - an echo of intrauterine life, located in close proximity to the opening of the nasolacrimal duct in the lower nasal passage.

The nasolacrimal duct should normally open into the lower nasal meatus

Stagnation of tears leads to the proliferation of bacteria and inflammation of the tissues surrounding the lacrimal sac. In this case, redness and swelling of the paranasal area are noted. This situation is not at all harmless. The spread of infection can cause serious consequences:

Probing of the nasolacrimal duct: the essence of the method

Probe is a medical term for a special instrument for examining the patency of narrow closed body cavities.

Cylindrical metal probes are used to probe the nasolacrimal duct.

Probing of the nasolacrimal duct is carried out to restore the patency of the tear outflow tract and remove the membrane covering the opening in the lower nasal passage. A number of signs indicate its presence:

In these cases, a conservative technique can help - massage of the lacrimal sac. Under the pressure of the accumulated liquid, the membrane can be eliminated and the outflow will be restored. However, this measure may not be effective. In this case, the probing method is used.

Using an instrument inserted into the nasolacrimal canal, the doctor expands its lumen and restores patency. At two months of age, the first attempts are made to probe through the lower nasal passage without anesthesia.

If there is no effect, a similar procedure can be repeated twice more with an interval of five to seven days. If problems with lacrimal drainage persist after reaching the age of six months, probing is carried out through the opening of the canal in the lower eyelid.

Probing with a special instrument allows you to restore the patency of the nasolacrimal duct

The main advantage of this method is that there is no need for anesthesia or incisions. The main disadvantage is that even several similar procedures may not have the desired effect. In this case, a radical intervention is used - dacryocystorhinostomy, with the goal of creating an outflow for tears into the nasal cavity through surgery.

Dacryocystorhinostomy creates an artificial connection between the nasolacrimal duct and the nasal cavity

How to treat dacryocystitis - video

Indications and contraindications for sounding

Probing is prescribed by a doctor in the following situations:

The main contraindication is an acute purulent process in the area of ​​the lacrimal sac (dacryocystitis). In this case, the procedure is carried out only after the symptoms have subsided against the background of antibiotic therapy. Probing is usually prescribed at the age of two to three months, but the doctor may perform the procedure earlier if the child’s condition requires it.

Preparation for the procedure and method of execution

On the eve of the procedure, an ophthalmological examination is required. The doctor examines the eyeball and retina. Anesthesia is performed by instilling an anesthetic drug into the eye. The procedure is carried out using a special probe inserted through the lower lacrimal punctum. Then the nasolacrimal duct is washed with an antiseptic solution to prevent tissue infection.

Rinsing the nasolacrimal duct is a mandatory stage of the intervention.

The procedure ends with checking the effectiveness of the intervention. To do this, a cotton swab is inserted into the child’s nose, then a dye is dropped into the eye. After a short time it should pass through the nasolacrimal duct. In this case, the paint will be found on the turunda, after which the probing ends. The intervention lasts on average about ten minutes.

Features of postoperative care

After probing, it is necessary to strictly follow the recommendations of the ophthalmologist. In most cases, antibacterial drugs are prescribed in the form of eye drops. On the recommendation of a doctor, massage the lacrimal sac area. After the procedure, slight redness of the eye and nasal congestion may be observed for some time. Watery eyes may persist for two weeks. It is allowed to bathe the child on the day of the intervention.

Massaging the lacrimal sac will help improve the patency of the nasolacrimal duct.

Prognosis and complications

One procedure of probing the nasolacrimal duct may not completely solve the problem. The doctor may subsequently prescribe the intervention again. If signs of obstruction persist, surgical connection of the nasolacrimal duct and the nasal cavity is used.

After the procedure, the following consequences are possible:

In these situations, it is necessary to consult a doctor to determine the cause and prescribe adequate treatment.

About 5% of newborns suffer from dacryocystitis. It is diagnosed only in infants in the first days or weeks of life. In such cases, probing of the lacrimal canal in newborns often serves as treatment.

What is dacryocystitis and the causes of obstruction of the lacrimal canal

In the mother's womb, the baby is surrounded by amniotic fluid. To prevent fluid from entering the tear ducts, a gelatin plug (mucous and epithelial particles) is formed in them. It clogs the tear ducts until the moment of birth. With the baby’s first breath, it breaks and self-cleansing occurs through the natural outflow of fluid.

In cases where the plug does not come out, inflammation develops due to stagnation of tears and the proliferation of bacteria. This is either obstruction of the lacrimal canal in an infant. Dacryocystitis responds well to treatment and most often children are healthy by 2-3 months.

5 signs of blocked tear ducts: how to recognize the disease in time

Dacryocystitis is a consequence of inflammation of the lacrimal duct

The symptoms of the disease are very similar to conjunctivitis.

Hence the improper treatment of tear duct obstruction in newborns, which results in only temporary relief from anti-inflammatory drugs.

And soon a new exacerbation of the disease follows.

Such cases lead to the need to break through the gelatin plug.

To prevent dacryocystitis, parents should carefully monitor the symptoms and signs of the disease. Blockage is manifested by the following symptoms:

• swelling under the eye, redness;
• continuous tearing (eyes are constantly wet and full of tears);
• swollen, heavy eyelids;
• In the morning, the child’s eyes become very sour, the eyelashes are glued together, and dry brownish-yellow crusts are noticeable around the eyes.

Mucus or pus is “hidden” in the lacrimal sac. If you lightly press or massage the area of ​​swelling, a cloudy, purulent fluid will come out of the canal into the eye cavity.

Reznik Evgenia Aleksandrovna, Family Clinic “Medis+”, ophthalmologist, Ivanovo

Dacryocystitis is known for serious exacerbations: stretching of the lacrimal sac from excess fluid leads to tissue melting and infection in the brain.

Prolonged dacryocystitis causes discomfort, so children are restless, often cry, and are capricious.. Possible increase in body temperature. You can learn how to bring down a child’s temperature from our

Monitor the condition of both eyes. Obstruction often develops in one eye, but it is possible that infection can spread to the healthy mucous membrane of the other eye. Hence – conjunctivitis and blockage in one bottle.

Treatment of dacryocystitis with massage

Often, the gelatin plug or rudimentary film comes out on its own by the third week of life without medical intervention. At the same time, parents themselves actively help in removing the plug by massaging the area around the eyes.

During the massage, your hands should be clean

Massage for obstruction of the lacrimal canal in newborns is very simple to perform. The main task is accuracy and sterility.

The following massage procedure rules must be observed:

1. Before the massage, one of the parents washes their hands thoroughly. Nails should be short and filed so as not to injure the thin, delicate skin around the eyes.
2. It is necessary to prepare a solution to cleanse the eye of secretions. To do this, dissolve 1 tablet of furatsilin in a glass of boiled warm water. Tablets can be replaced with warm decoctions of chamomile or calendula, which are pre-filtered.
3. A cotton swab (sterile only!) is moistened in the solution and gently wiped the eye from the outer corner to the inner. If necessary, change the tampon to a clean one.
4. The massage is performed with the index finger, starting with light pushes, along the nose to the inner corner of the eye. Repeat 5-10 times.
5. At the inner corner of the eye we feel the tubercle and its highest point. Lightly press down the tear duct and repeat 5-10 movements.

The movements should be continuous, and the massage should provoke discharge from the lacrimal canal.

In the video, eye massage for obstruction of the lacrimal canal is clearly shown in detail.

After the procedure, antibacterial drops are instilled into the eyes. Levomycetin and Vitabact are suitable. You cannot use Albucid drops. They tend to crystallize, so there is a high risk of worsening the blockage.

Massage is carried out regularly: from 5 to 7 times a day. The course lasts from two weeks or longer. The ineffectiveness of massage means that it is necessary to probe the lacrimal canal in newborns.

Savchenko Sergey Vladimirovich, Medical Center “ENT Plus”, otolaryngologist, Perm

Probing is a harmless procedure, the effectiveness of which is difficult to overestimate. Most of the worsening blockages are due to the fact that mothers and grandmothers delay the operation.

They treat with folk remedies, home-grown ointments. The result is sad: the disease worsens, the child is exhausted.

Main reason for probing

Sometimes massage does not give results. If the age is approaching six months, and obstruction of the lacrimal canal in newborns cannot be treated, the massage is stopped, and in this case medical intervention is necessary.

After 6 months of age, the rudimentary film thickens to such an extent that it becomes impossible to push it out by massage. The optimal age for probing is 3.5 months.

The most effective method is considered to be probing the tear ducts in infants at an early age. The procedure is completely safe, but worries parents.

The essence of the probing procedure: why you should not be afraid

The name of the procedure is scary and sounds like a death sentence, so parents should know how to probe the lacrimal canal in newborns up to six months old.

Do not be afraid of the probing procedure; it is very simple to perform and is safe.

Probing the lacrimal canal in newborns takes no more than 20 minutes, is carried out under local anesthesia and in several simple steps:

1. Drops are used as anesthesia (for example, Alcaine 0.5% is popular). Their action lasts on average 15 minutes. The child completely loses sensitivity in the eye area.
2. The Sichel probe is inserted into the lacrimal canal and dilated, and then the Bowman probe is inserted through it.
3. The latter breaks through the plug and clears the tear duct from blockage.
4. The canal is washed with saline and disinfected.
5. The Vesta test shows how well the canal is cleaned.

The West test involves instilling a colored solution (collargol or fluoreiscein) into the eyes. A swab is inserted into the spout to absorb the colored solution if the passage is clear. The canal is considered clean if the tampon is colored within 5-7 minutes. A long wait of 10 minutes or more indicates a partial blockage - this requires repeated probing.

The procedure usually goes well, and the child is active within a few hours.

After probing, it is necessary to provide eye care for a week or more.

Caring for a child after the probing procedure

During the first 10-15 days, the child may experience nasal congestion, slight bleeding, and discharge.. Sometimes they go away faster, but don't worry if they don't.

Antibiotics are instilled into the eyes for the first 5 days. It is recommended to rinse the eyes if the discharge is heavy.

Kostryukov Alexander Vladimirovich, Ophthalmological Center of Professor Basinsky, ophthalmologist, Orel

In my practice, there are not isolated cases when a child is brought in with exacerbations of dacryocystitis, when vision is seriously threatened.

Conventional probing of the lacrimal canal in newborns has consequences only if the child has congenital pathologies in the structure of the facial skeleton or tissues.

Contraindications for probing

Cellulitis of the lacrimal sac and congenital curvature of the nasal septum are considered contraindications to probing. However, doctors consider situations with dacryocystitis in newborns individually.

Parents' opinions

Zheleznyak Alisa Viktorovna, 28 years old, Tver

We suffered a lot with the blockage of the canal. I gave my daughter a massage until she was six months old, but it didn’t help. We made it to the deadline, but still had to probe. And twice, because the first time they punched it poorly, as the cork had hardened.

Let me tell you, there is nothing wrong with probing. Yes, the baby is crying, but it’s better to be patient for a while than to treat exacerbations.

Porokhova Anastasia Vladimirovna, 24 years old, Rostov-on-Don

My baby's eye was watery and purulent until he was 4.5 months old. I washed it with herbal decoctions, my own milk, and dropped drops, but relapses happened all the time. I did massage 2-3 times a day, but it didn’t help. When the child was 3 months old, the ENT specialist insisted on probing, but I was terribly afraid and was stalling for time.

After another month, the eye began to fester more severely. And then I took up the massage! I kneaded the area around the eye 10 times a day. Of course, the child is capricious because massaging the inflamed eyelid is irritating. But everything helped! I saw a barely noticeable film of pus come out.

I washed everything and put some drops in my eye. Since then, the eyelid has quickly recovered and by six months we were completely healthy!

Ivashchenko Alla Olegovna, 21 years old, Moscow

The child is already 1.5 years old, and the tears are still there. We did probing three times and everything went according to the established pattern: surgery, we recover and after a month and a half the eye is full of pus. I do massages, drops, decoctions, and rinses as prescribed by the doctor. Tomorrow we go to the appointment again.

In conclusion, we note that the health status of each child has its own characteristics. Only a doctor has the right to draw conclusions and make diagnoses. A timely visit to the doctor is an opportunity to get rid of the disease quickly and almost painlessly.

Obstruction of the nasolacrimal ducts is a fairly common pathology: it affects about 7% of newborns. This disease can develop in older children and even adults, but infants are most susceptible to it. Many mothers, noticing their baby's eyes turning sour, panic. They are afraid to go to the doctor, trying to heal the child with many months of rinsing and massages. Experts, however, recommend not torturing infants with daily unpleasant procedures, but to eliminate the problem in a few minutes using a probing procedure.

Why is tear duct probing necessary?

A child in the womb does not have free communication between the nasal cavity and the nasolacrimal duct. The exit hole is closed by a thin membrane, which in most children disappears by the time of birth. In this case, the nasolacrimal duct is usually blocked with a gelatin plug, which prevents amniotic fluid from entering the baby’s body. When a child is born, begins to breathe and cry, this mucous lump comes out of the duct, enters the nose and is removed by obstetricians.

If at birth the nasolacrimal duct is not freed from the natural plug, the baby develops dacryocystitis

However, it also happens that due to anatomical features or anomalies, the plug does not come out of the nasolacrimal canal. Because of this, stagnation occurs in it. After some time, the newborn develops dacryocystitis - complete or partial obstruction of the lacrimal ducts. The baby's eyes first water, and then begin to fester and become inflamed.

In 80% of cases, dacryocystitis disappears spontaneously by 3–4 months, and massage and instillation of drops only accelerate this process.

Dacryocystitis can be either congenital or acquired as a result of injuries, inflammatory processes in the eyes or nose, as well as various diseases. This disease can affect both children and adults of all ages. However, while acquired dacryocystitis often requires complex surgical interventions, the congenital form usually resolves spontaneously or as a result of rinsing and massage.

If, after conservative treatment, the baby’s eyes continue to fester, doctors refer the child for probing - mechanical restoration of the patency of the nasolacrimal duct using a special instrument - a probe. The procedure is performed under local anesthesia and does not last long. However, probing does not guarantee a cure: after a certain period of time, the discharge may reappear. With repeated intervention, the probability of complete recovery is 95–98%.

Constant tearing is the first sign of dacryocystitis

Over time, the gelatin plug in the nasolacrimal duct hardens. Therefore, the older the child becomes, the more traumatic and painful the probing procedure will be for him.

As a rule, doctors are in no hurry to send babies with “sour” eyes for probing. They often recommend that parents wait up to 3-4 months to get rid of the problem with the help of massages and eye drops. If by this time there is no improvement, probing is performed, which usually completely eliminates all symptoms.

Indications and contraindications for the procedure

Only a pediatric ophthalmologist can diagnose dacryocystitis in a baby, but any attentive parent can suspect this disease. Obstruction of the lacrimal ducts is often confused with conjunctivitis. These diseases are really similar: their main symptom is purulent discharge from the eyes. However, if conjunctivitis can be easily treated with antibiotic drops, if the nasolacrimal ducts are obstructed, such treatment will be ineffective.

A clogged tear gland is an ideal place for bacteria to grow, causing pus to leak from the eye.

The main symptoms of dacryocystitis are:

• constant lacrimation;
• redness of the eyes;
• purulent discharge;
• swelling of the inner edge of the eye;
• discharge of pus when pressing on the lacrimal sacs.

As a rule, after sleeping or crying, the intensity of the discharge increases. In order for a child to see normally, pus has to be removed from the eyes quite often.

If unpleasant symptoms persist for three or more months, doctors refer the baby for probing of one or both nasolacrimal ducts. This, however, only applies to those cases where the obstruction is not caused by complex pathologies. Probing is not prescribed for:

• congenital defects in the structure of the nasolacrimal duct;
• deviated nasal septum;
• blood clotting disorders;
• high temperature and general poor health.

Since the procedure is performed under local anesthesia, before starting it you need to make sure that the baby is not allergic to the painkiller.

A deviated nasal septum can also cause dacryocystitis, but probing will not help with this pathology

Diagnostics and preparation for probing

Before making a final diagnosis, the doctor usually performs the Vesta test. To do this, a dye is dropped into the problem eye, and a cotton swab is placed in the nose. If the nasolacrimal duct is open and the cause of the purulent discharge is bacteria that cause conjunctivitis, the cotton wool will become colored. Otherwise, the ophthalmologist diagnoses dacryocystitis and refers the baby for probing.

Before the procedure, the child must be examined by the following doctors:

• pediatrician - to assess the general condition of the body;
• a neurologist - to exclude diseases for which anesthesia is contraindicated, as well as to assess the neurological status;
• otolaryngologist - to assess the structure of the nasal passages and detect pathologies such as a deviated nasal septum.

The baby also needs to undergo a blood clotting test, and preferably general urine and blood tests.

The probing procedure does not require special preparation: the child does not need to be kept from hand to mouth and undergo cleansing procedures. An anesthetic drug in the form of drops is injected directly into the eyes, after which you can begin cleaning the nasolacrimal ducts.

An ophthalmologist will refer the child for probing, but before the procedure the baby must be additionally shown to a pediatrician, neurologist and ENT specialist.

How is probing of the lacrimal duct performed?

The probing procedure is carried out in several stages:

1. The baby is swaddled and his head is fixed. Complete stillness is needed so that the baby does not twitch while the doctor works with a probe in his eyes.
2. An anesthetic drug is instilled into the eyes (in some cases, mask anesthesia may be necessary).
3. The doctor inserts a sterile thin probe into the nasolacrimal duct, widening it and clearing the soft plug.
4. The insertion site of the probe is washed with an antiseptic solution.
5. The child is freed from diapers and given to his parents.

The whole procedure takes from 5 to 10 minutes. If the child is more than 6 months old, then the plug has already hardened, so instead of probing, bougienage is performed. To do this, the nasolacrimal duct is not cleaned, but pierced, making a through puncture in the plug.

Like probing, bougienage is absolutely safe and gives the baby a minimum of discomfort. The procedure is carried out under anesthesia, so children scream not from pain, but from tight swaddling and fear of doctors.

Probing is a low-traumatic operation

To minimize the risk of complications, probing should be carried out by a qualified pediatric ophthalmologist in a good clinic equipped with all the necessary equipment.

Caring for a child after probing

The effect of the procedure is usually noticeable within a few days. The eyes stop watering and fester, and the child’s condition finally returns to normal. The baby can be washed, bathed and all the usual procedures performed on him, but doctors recommend monitoring his eyes for at least another month. For the first 7 days after probing, young patients need to instill antibacterial drugs and undergo a special massage aimed at improving the patency of the tear ducts.

The doctor who performed the probing must show which areas need to be massaged and with what intensity. Typically, circular movements or low-intensity pushes with the fingertips are recommended in the direction from the upper part of the inner corner of the eye along the nose to the mouth.

During the massage you must adhere to the following rules:

1. Before the procedure, cut your nails and wash your hands thoroughly or wear sterile gloves.
2. If pathological secretion has accumulated in the eyes, carefully squeeze out the pus and rinse them with chamomile decoction or a warm solution of furatsilin in a ratio of 1:5000. Make sure that the contents of the diseased eye do not get into the healthy eye or into the ear.
3. After the massage, drip your eye with an antibacterial solution. Levomycetin or Vitabact are suitable.
4. Massage up to 5 times a day. It is best to do it before feeding: after eating, many children fall asleep, and the drops have an antibacterial effect during sleep.
The intensity and sequence of movements when massaging the lacrimal duct must be demonstrated by a doctor.

If the parents followed all the doctor’s instructions, and within a month the discharge from the eyes did not disappear, it means that the child was given an incorrect diagnosis or the probe did not penetrate the nasolacrimal duct completely. In any case, you need to contact a specialist who will develop a further strategy for examination and treatment.

Possible complications

With proper probing, the risk of negative consequences is minimized. The only possible complication is the occurrence of adhesions and blocking of the nasolacrimal duct. This is precisely what massage is aimed at preventing. If you do it conscientiously 3-4 times a day, the baby will not need repeated probing.

Viral infections pose a great danger to the baby in the postoperative period. Due to a common runny nose, pathogenic microorganisms can penetrate into the injured opening of the nasolacrimal duct, which usually provokes a relapse of the disease. Therefore, for 1–2 months after probing, it is better for the baby to avoid children’s groups and crowded places.

In most cases, medical intervention is easily tolerated by children, and repeated surgery is not required. Bloody discharge is acceptable for 1–2 days, but the eye may continue to water for up to 2–3 weeks. If lacrimation persists after this period, the child should be re-examined and, possibly, probed again. As a rule, after the second operation the problem is completely eliminated.

Video: dacryocystitis in children - causes and treatment

Probing is an easy and effective surgical intervention. If this manipulation is performed correctly, the risk of complications is minimal, and the likelihood of a favorable outcome is maximum. However, before you decide to probe, you need to try to restore the patency of the nasolacrimal duct using conservative methods, using massage and rinsing. If, despite all efforts, the baby’s eyes continue to water, do not be afraid of the operation: it will go away very quickly and will cause only minor inconvenience to the child.

The purpose of this medical procedure is to open a tear duct that is blocked. If a child under one year of age is prescribed sounding, it means he has been diagnosed. It can begin either immediately after birth or some time later. In any case, there is no point in delaying intervention; it is better to carry out probing as early as possible.

Why do tear ducts get clogged?

When a child goes through the stages of intrauterine development, his tear ducts are protected at this time by special films consisting of thin connective tissue. This is necessary to protect the eyes from amniotic fluid. At the moment when the child is born, the films should be removed, but sometimes this does not happen, and the channels, both or one, remain closed. Because of this, inflammation develops in them.

By the way. As soon as the baby takes its first breath and first cry after birth, air pressure builds up in the nose, which causes the protective duct film to burst. Usually this happens easily and goes unnoticed by either the child or the parents.

But sometimes the film does not burst because its structure is too dense, or the first breath was shallow, or the cry was weak. The pressure in the nose is not enough to remove the film plug, and it remains, continuing to block the tear opening.

Since tears are normally produced constantly, they must flow down the canal and away from the eye. When the channel remains closed, this cannot happen. The tear fluid forms stagnation in the “sac” it forms and gives rise to serious inflammation, which cannot be eliminated otherwise than by clearing the tear duct, giving the stagnant fluid an outlet.

Important! In a blockage condition, tears lose their ability to flow into and move through the tear duct. As they accumulate, they aggravate inflammation.

For what reasons does dacryocystitis develop in newborns?

The main reasons for the occurrence of this pathological situation include several anomalies that occur with a normally developed system of tear formation and secretion. Their character can be either congenital or independent of developmental defects.

Table. Causes of dacryocystitis.

Cause of occurrence	Description
Developmental anomalies	Even in the womb, the child’s eyes or eyelids, nose, and some skull bones begin to develop incorrectly.
Genetic pathologies	Those that violate the structure of the face in some way.
Congenital pathology of the lacrimal duct	The child's nasolacrimal duct is too short or narrow.
Acquired obstruction	Most often it occurs due to the fact that the canal is blocked mechanically with a so-called plug. The most common cause of dacryocystitis.
Eye infection	It can begin both in the womb and after birth, the second most popular cause of duct closure and tear obstruction.
Tumor	A tumor-like formation blocking the nasolacrimal duct is rare, but such cases have still been recorded in medicine.

Important! Blockage of the tear ducts by plugs is the most common reason why a child may undergo probing surgery.

How to recognize dacryocystitis and distinguish it from conjunctivitis

The very first sign of obstruction is tear stagnation, but it is not noticed immediately, although even in a newly born baby who is not crying at the moment, with dacryocystitis you can see an accumulation of tears in the lower part of the inner corner of the eye.

1. Chronic lacrimation.
2. Enlarged eyelids due to swelling.
3. Sticky eyelashes.
4. “Souring” of the eye, accompanied by discharge from it, especially abundant after a night’s sleep.
5. Discharge from white-yellow to greenish (color indicates the stage of the inflammatory process).

If you don't try to fix the problem, the symptoms will get worse after a while.

1. Pain appears in the eye, causing the baby to cry even with a light touch to the area of ​​the inner corner.
2. First the corner turns red, then the change in skin color spreads to both eyelids and the nose.
3. The discharge becomes purulent, accumulates and dries out.
4. A purulent “bag” swells near the inner corner.
5. The temperature rises and stays.

By the way. At this stage, if not at the initial stage, any parent should be alarmed and take the child to the doctor. But it happens that, following the advice of grandmothers, mothers try to cope with the problem with folk remedies, washing their eyes with decoctions and applying various kinds of compresses to them.

If, when aggravated symptoms appear and are constantly present, you ignore the problem and postpone a medical consultation, at which the doctor will suggest probing the canal, terrible things can happen.

Important! In a child, with prolonged blockage and inflammation of the lacrimal canal, pus spreads through the tissue, forming phlegmon. Then it breaks into the sinuses, reaches the brain, and meningitis begins.

But just as often as the unnoticed first stage of canal blockage, the following thing happens - parents notice that something is wrong with the child’s eyes, and, after observing the baby for some time, they themselves make a diagnosis - conjunctivitis. Moreover, there will always be an older relative or neighbor who will tell you that everyone’s eyes fester in babies, and this is normal, this is childhood conjunctivitis. You just need to rinse with chamomile, bay leaf, and other available means, up to and including instilling breast milk.

Advice. The symptoms of these two ailments are similar, and not always even a pediatric eye doctor can distinguish them at first glance. But there is a way to clarify the diagnosis - the baby is first prescribed drops for conjunctivitis, and if they do not improve the situation, then there is reason to assume that the tear duct is blocked.

If the ophthalmologist suspects dacryocystitis, then a set of diagnostic procedures is prescribed, which allows not only to make an accurate diagnosis, but also to identify the cause of the formation of stagnation and its exact location. The following diagnostic actions are carried out.

1. Visual examination to determine the condition of the eyes.
2. A smear of discharge to rule out an infectious nature.
3. Channel test to determine condition. Collargol (a dye the color of iodine tincture) is instilled into the eye. The amount of it that the doctor places into the eye for testing should disappear within five minutes if there is normal tear flow. If the eye remains stained for five to ten minutes, a tear drainage obstruction is diagnosed.

By the way. If the color lasts more than ten minutes, testing continues to prove or disprove complete loss of tear drainage function and to obtain definitive confirmation of obstruction.

Complete confirmation of obstruction is provided by the Vesta test. It can be called similar to canal, but its second name is nasal, since the main result will be obtained in the patient’s nose. A loose tourniquet of cotton wool is placed in the nostril and collargol is instilled into the eye. Coloring of the cotton cord should occur within three to five minutes. If it starts later, or the cotton wool is not colored at all, an obstruction is established.

By the way. At this stage, before prescribing a probing procedure, the doctor must rule out structural pathologies in the patient's nose or skull.

Probing purpose

In fact, many parents are in vain afraid that as soon as the baby’s eye festers, they will immediately begin to pierce the tear duct with a probe. The treatment strategy for dacryocystitis is always two-stage. And at the first stage, if there are no direct indications for urgent probing, treatment is applied.

Important! A two-stage scheme is used if the baby has not reached six months of age. In cases where the child is not yet a year old, but has already turned six months old, most often, canal cleaning will be prescribed first, and then subsequent treatment, restoration and hygienic care.

Treatment is used in the same way as the first remedy, in cases where the anatomical characteristics of the child and his physiology allow him to wait until the film opens. In a number of such cases, probing can be avoided - the eye goes away.

What is included in the first stage of treatment

Hygienic eye treatment

Twice a day, with cleanly washed hands and short nails, parents wash the child’s eyes with furatsilin in solution or with ordinary boiled, but not hot water. Discs or gauze for washing are taken separately for each eye and thrown away after use. Washing is carried out by moving inward along the eyelids, from the temple.

Eye massage

In fact, it is not the eye that needs to be massaged, but the lacrimal sac. This can be done by parents or other relatives. You cannot massage with nail polish or if your nails are not cut short. Hands are washed with soap and dried with a sterile towel.

The technique of the massage procedure is as follows.

1. Lubricate the area from the nose to the eye with a neutral cream.
2. In the direction from the wing of the nose up to the corner of the eye, draw 10 straight lines with your index finger.
3. If liquid is released, collect it on a cotton pad.
4. In the same direction, make 10 circular movements with your index finger, as if “drawing” a spiral.
5. Cleanse the skin of secretions again.
6. Draw 10 straight lines in the opposite direction from the corner to the wing of the nose.
7. Near the corner of the eye, alternately tap with your index and ring fingers, creating vibration, for 10 seconds.
8. Cleanse the skin of secretions and cream.
9. Take medications prescribed by your doctor.

If the first stage of treatment does not bring results for two months or more, or if the child is approaching eight months of age, probing will be prescribed.

Before the appointment, the child is carefully examined by a pediatric ophthalmologist together with a pediatrician. Cough, runny nose, the presence of a general illness, malaise, and other eye diseases are excluded. Blood tests are performed to determine the effects of drug allergens and preparations used during the insertion of the probe.

The second stage is the probing procedure

It is carried out in a clinic setting, on an outpatient basis. A pediatric ophthalmologist carries out probing with the help of a nurse or the child’s parents.

By the way. Half an hour to an hour after the manipulation, the patient can go home, if the obstruction of the canal is not complicated by a severe form of infection. If there is an infection, probing will be done in a hospital and the child will be left under observation for several days.

It is necessary to swaddle the baby in order to immobilize as much as possible and eliminate the possibility of flapping the arms.

The nurse or parents hold the child and fix the position of his head necessary for the procedure. The doctor instills an anesthetic substance, the so-called local freezing, into the eye that will undergo manipulation.

By the way. Since the procedure is performed under local anesthesia, the child does not feel pain. But almost all small children cry loudly and hysterically during probing. This is due to fear and uncomfortable sensations from manipulation.

The doctor will need double probing - the lower and upper lacrimal canal.

1. First, the upper one is probed. To do this, the eyelid is lifted up at the angular inner point, and the first probe is inserted into the lacrimal punctum. It is called a Sichel probe and is used to widen the opening of the lacrimal opening. After it, first horizontally, a Bowman probe is immersed into the hole. When it is turned and placed in a vertical position, the protective film breaks through.
2. To clean and uncork the lower lacrimal canal, the lower eyelid is lowered down and to the side at the inner corner point. Further manipulations are carried out in the same order as for the top point.
3. After the manipulations, the nasolacrimal ducts, cleared of mechanical blockage, are washed with a special treatment solution.

By the way. If the child is less than two months old, due to the peculiarities of his physiology, endonasal sounding is possible. Anesthesia is not used in this case. The probe is inserted into the nasal passage and guided to the canal, then the passage freed from films is washed with antibiotics.

The third stage - after probing

It is necessary to carefully care for the manipulation area for two weeks after it is performed. To do this, a daily massage is performed using the technique described above in the first stage of treatment. The doctor will definitely prescribe eye drops containing an antibiotic to relieve inflammation and prevent the formation of new ones.

By the way. Most often (in 90% of cases), the procedure is sufficient and relapse does not occur. But it may happen that 100% cleaning did not occur, or the infection was introduced by parents during post-operative care. In this case, repeated cleaning with a probe is prescribed.

Many parents ask the question why cleaning should be done at the earliest possible age, without waiting until the child grows up. After all, perhaps a child older than one year will undergo surgery more easily than a baby. But according to statistics, 90% of successful soundings, which do not require repeated manipulations, are carried out on babies under one year old, and even up to eight months of age. After a year, the child endures everything much more difficult, the possibility of relapses and the need for repeated probing doubles. In addition, the operation for children over 12 months is most often performed under general anesthesia.

Complications

Probing is the most effective and least traumatic (albeit invasive) way to eliminate the inflammatory process in the lacrimal canal if the pathology cannot be treated conservatively. But it is used not only to remove film and free up tear ducts. A probe may also be inserted for diagnostic purposes to check the condition of the lacrimal canal or inject an antiseptic into it.

The injection procedure may be accompanied by complications of the following nature:

• rupture of the channel if the probe is selected incorrectly in size;
• rupture of a purulent sac with spillage of pus in the maxillary cavity;
• perforation of the bone wall, in which the probe penetrates into the nasal cavity;
• breakage of the probe in the canal, in which it will have to be urgently removed surgically.

Important! The appearance of blood after manipulation is not considered a complication; on the contrary, it indicates that the films blocking the tear outflow have been successfully removed.

What happens if you don’t probe on time and don’t clean the tear ducts? Inflammatory stenosis will develop. Cellulitis of the lacrimal sac will occur. Periorbital cellulite is formed. Sinusitis or entmoiditis may begin. The state of purulent inflammation can lead to meningeal sepsis. In rare cases, visual impairment develops. Thus, this operation is a relatively safe and, by far, the most effective means of relieving a child of obstruction of the lacrimal ducts and preventing the development of serious diseases that pose a threat to the baby’s health.

Video - Probing of the nasolacrimal duct

The birth of a child is one of the best moments that new parents experience. But there are situations when such a positive event is overshadowed by the words of doctors when they say that the child has pathological changes. Probing the tear duct in newborns is a common problem that you may encounter. So that parents do not panic, let's figure out what the danger of this procedure is and whether it is as serious as it seems at first glance.

Causes and characteristics of the disease

Quite often, after the birth of a child or during the birth itself, the baby may experience problems with the eyes. There are many reasons for these changes. These can be either congenital or acquired eye pathologies.

Acquired causes of eye diseases

• infection of the eyes when passing through the birth canal;
• colds;
• mechanical injuries;
• allergic reactions.

The occurrence of pathological changes occurring in the eyes of newborns is difficult to miss. The main symptoms are redness of the eyes with purulent contents, sticking of the eyelids and unusual discharge, with signs of dryness and peeling of the skin around the eyes. In addition to disruptions in the functioning of the lacrimal canal, the cause of deviation may be ordinary conjunctivitis or another infection.

But lacrimation - when a child cries, but his tears do not go beyond the eye, this is the first sign of a violation of the lacrimal canal. While the baby is in the womb, the tear ducts are closed with special contents. Nature did this in order to protect the child’s eyes from intrauterine infection. At the time of birth or immediately after it, the tear ducts should open on their own, but it also happens that this does not happen. If the change occurring is ignored, it can cause significant harm to the child’s health.

The need for probing of the lacrimal ducts

Blockage of the lacrimal duct or dacryocystitis is an inflammatory disease of the lacrimal sac of the eyes, caused by a narrowing of the lacrimal duct or its complete blockage. The development of this pathology can occur at any stage of life, both in infants and in adulthood. In order to confirm this diagnosis, it is necessary to consult an ophthalmologist. Specialists examine the baby's eyes and establish a diagnosis, identifying the causes of its occurrence.

When diagnosed with blockage of the tear ducts of the eyes, many parents panic. There is absolutely no need to do this, since timely treatment can cope with this pathology. If the cause of the disease is an infectious disease or conjunctivitis, then it is possible to use ordinary eye drops and classic eye rinsing. In this case, treatment will be aimed at eliminating the causes of the primary disease.

If the classical method of treatment does not bring a positive result, then parents are offered to undergo surgery on the tear duct. All parents who are faced with this question ask the same question: is this intervention dangerous? The answer in this case will be unequivocal, no! This operation is completely safe and does not have any consequences.

Refusal to carry out probing carries much more dangers than carrying out surgery. Untimely treatment of existing pathologies can cause significant harm to the child’s health. It must be remembered that the organs of vision are very sensitive to changes occurring in them. Therefore, even a minor infection can jeopardize the baby’s quality of life.

Features of the procedure

Before prescribing an operation, the doctor must make sure that the cause of the pathology is obstruction of the lacrimal canal. After conducting an in-depth diagnosis and taking into account all existing symptoms, the doctor decides to prescribe surgical intervention to eliminate the existing pathology.

Before setting the date for the operation, the doctor conducts additional research methods. This is done to ensure that the child is healthy. As a rule, in this case, a general urine and blood test is prescribed. If your child has a history of allergies, a consultation with an allergist may be necessary.

The procedure itself takes place under local anesthesia. I place the child on the operating table, and his position is fixed. Afterwards, an anesthetic drug is instilled into the open eye. As soon as the anesthesia takes effect, a special device is inserted into the eye, which breaks the resulting plug. Immediately after completion of the procedure, the eyes are washed with antiseptic drugs. During the procedure, a minimum amount of time is spent, no more than 5 minutes.

Current issues on the topic

Is there a way to avoid surgery?

The operation is prescribed as a last resort if there are no other methods to solve this issue. Before you begin using medication or decide to undergo surgery, you should try massage therapy. Stroking movements from the corner of the eye along the nasal septum should help break up the resulting plug. Light pressure movements can push it out of the lacrimal stool. As practice shows, this type of massage has good results in most cases.

Is there any danger from this procedure, can it negatively affect the child’s vision?

Modern treatment methods used in ophthalmology are completely safe. Lack of timely treatment will cause significant damage to vision. To prevent this from happening, you should not avoid performing the operation. After probing, simple preventive measures may be required to protect the infant's eyes. The main complication may be the possibility of infection.

Is it necessary to go to the hospital for probing?

The operation occurs very quickly; many children undergo it in a clinic setting, if it has an operating room. Since it is done only in a sterile office. If the clinic does not have a local operating room, then hospitalization may be required.