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泪器病英文版


Tear secretion and excretion

Lacrimal duct stenosis or obstruction
? Etiology: ?

(1) functional epiphora: No obvious of lacrimal duct obstruction, Lacrimal duct flushing flux, the primary cause is the orbicularis oculi muscle relaxation, cause eyelid and abnormal lacrimal point location, lacrimal point can't touch tear lake, tear pump action weakened or disappeared, tears can not enter the lacrimal duct.

? (2) Organic tears overflow: Obstruction or stenosis of

the nasolacrimal duct to the nasolacrimal duct. ? Clinical manifestation: ? The main symptom is overflow of tears ? Obstruction occurred at the end of the nasal lacrimal sac and had dacryocystitis, with purulent secretions flowing back into the conjunctival sac

? Treatment ? ? ? ? ? ?

Determining the location of the obstruction is important for the choice of treatment options Common inspection methods: a、The dye test (2% uranin solution) is mainly used for children b、 Irrigation of lacrimal passage c、 Probing of lacrimal passage d、X ray lipiodol radiography showed size and obstruction of the lacrimal sacPosition。

Common treatment
? (1)Stenosis or obstruction of lacrimal duct in infants:

Due to the hypoplasia of the lower end of the nasolacrimal duct, there is no “duct” or membranous obstruction. Try finger regular compression of lacrimal sac area, since the orbital line between the medial and eye down oppression, oppression after several antibiotics eye water, 3-4 times a day, persist for several weeks, most children can be cured, if conservative treatment is invalid, half a year after considering the lacrimal passage。

Neonatal dacryocystitis

Epiphora and matting

Infrequently acute dacryocystitis

Probing of lacrimal passage

After application of a topical anesthetic, the probe is carefully introduced into the lower lacrimal system. The puncta are dilated and then the valve of Hasner is opened (a and b). In infants six months or older, the procedure is best performed under short-acting general anesthesia.

? (2)Functional tear overflow:Try the zinc sulfate

and adrenaline solution drops, shrinkage of tearsCystic mucosa。 ? (3)Stenosis, occlusion, or absence of tear: Dilate or detect with a dilator. Eversion of the lower part of the eyelid due to ectropion can correct ectropion。

? (4) Lacrimal canaliculi obstruction: The laser

treatment method guides the fiber to the blocking position through the probe, and uses the gasification effect of the pulse YAG laser to break the obstruction, and after the operation, the intubation or the thread is added to improve the curative effect。 ? (5)Nasolacrimal duct stenosis: Feasible dacryocystorhinostomy

Two :Chronic dacryocystitis
? More common in middle-aged and elderly women ? Etiology: Nasolacrimal duct stenosis or obstruction,

resulting in tears stuck in the lacrimal sac, accompanied by bacterial infection. Common pathogenic bacteria are Streptococcus pneumoniae, Streptococcus, Staphylococcus and so on

Chronic dacryocystitis
Epiphora and chronic or recurrent unilateral conjunctivitis

Painless swelling at inner canthus

Expressed mucopurulent material

Treatment - DCR

? Clinical manifestation: ? The main symptom is overflow of tears. ? Squeezing the area of the lacrimal sac with the

fingers, leaving mucus or purulent discharge from the lacrimal point. ? When the lacrimal passage is flushed, the irrigating fluid flows back from the upper and lower lacrimal points, and has mucous secretions at the same time.

? Hyperemia of the bulbar conjunctiva occurs due to

secretion stimulation.As the secretion remains, the tear sac expands and forms mucocele of the lacrimal sac。

Treatment
? (1)Drug treatment: available antibiotic eye drops of

water(0.25% chloramphenicol, eye water, q2h, 0.1% furosemide, nose drops, nose TID) drop first, then remove the secretions or tear the lacrimal passages. ? (2)Surgical treatment: commonly used surgical dacryocystorhinostomy. In elderly patients, removal of the lesion with tear removal is considered, and postoperative symptoms of tear overflow remain.

Dacryocystorhinostomy

Three:Acute dacryocystitis
? Etiology: Most patients, on the basis of chronic

dacryocystitis (not treated in time), have a strong virulence or a decreased resistance to the organism. The most common causative agent is streptococcus.

? Clinical manifestation: ? Suffer from bloodshot eyes, tears, purulent

discharge, redness, tenderness, pain and tenderness in the area of the lacrimal sac.

Treatment
? Early local hot compress, systemic and local use of

antibiotics to control inflammation. During the inflammatory phase, lacrimal passages or lacrimal passages should be removed so as not to cause infection to spread.If the inflammation fails to control, abscess formation, incision and drainage, drainage strips are placed to heal the wound.After the inflammation has completely subsided, it is treated by chronic dacryocystitis.

Third:tear secretion system disease
? 1、Acute dacryocystitis: ?

etiology:most of them are caused by bacteria and virus infection, and Staphylococcus aureus or gonococcus are common.

? Clinical features: the eyelid or orbital lobes which may

involve the lacrimal gland respectively or at the same time exhibit local swelling and pain above the orbit. The edema of the upper eyelid is S shaped, and the anterior ear lymph nodes are enlarged. Palpable palpable mass, tenderness, conjunctival congestion, edema, purulent discharge.Treatment: (1) bacterial or viral infection, should be systemic antibiotics or antiviral drugs.(2) abscess formation, incision and drainage in time.

Chronic Dacryoadenitis
? [cause of disease] more, can be caused by benign

lymphocytic infiltration, lymphoma, leukemia, tuberculosis, such as sarcoma may be manifested in bilateral chronic dacryocystitis. Biopsy is the cause of the disease.[clinical manifestations] lacrimal gland enlargement, generally no pain, may be accompanied by ptosis.[treatment] aims at the pathogeny and the primary disease treatment.

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