Obstruction of the lacrimal gland in children

Blockage of the tear ducts is very common in children, this is not a very dangerous disease. However, if not detected early and treated promptly, it can lead to many serious consequences: inflammation, infection, itching, even blindness. There are many symptoms that are easy to notice in the early stages. The following article will provide parents with necessary information when taking care of young children, monitoring when experiencing unusual symptoms to quickly take the baby to an eye specialist hospital or medical center for doctors. thorough examination and treatment.

content

• 1. What is lacrimal gland?
• 2. Overview of occlusion of the lacrimal gland
• 3. Causes of blocked tear ducts in children
• 4. Symptoms of blocked tear glands
• 5. Subjects at risk of occlusion of the lacrimal gland
• 6. Preventing blocked tear glands
• 7. Diagnosis of blocked tear glands
• 8. Measures to treat blocked tear glands
• 9. Summary

1. What is lacrimal gland?

The lacrimal gland is formed in the skeletal system of the eyes, starting from the nasolabial fold and the eye is located between the outer nasal sprouts and the maxillary buds.

In each person's eye cavity, above and below each eye, there are tear glands. The lacrimal gland is only the size of a pea, round and flat.

• Structure of tear glands

The lacrimal gland is located inside the upper, outer corner of each eye.

The lacrimal gland consists of 2 parts:

• The main lacrimal gland will be located between the lacrimal fossa of the orbital bone wall and the human eyeball. It consists of two parts: the lacrimal gland and a part of the lacrimal gland.
• The rest are accessory lacrimal glands: consisting of many small lacrimal glands, located just below the conjunctiva.

Structure of the lacrimal gland

The role of the lacrimal gland

• This gland is responsible for supplying tears to keep the surface of the eye moist and smooth. Tears help reduce friction, removing dust and debris from the eye to prevent infection.
• In many cases, when the eye is irritated, it will produce a lot of tears. Tears (secretions) will wash away the front part of the eyes, following the tear ducts down to the sinuses. The secretion has the effect of making the cornea always wet, has a slight antibacterial ability.
• Normally, the lacrimal gland produces only a small amount of tears. In the early morning, when you wake up, in 16 hours, the lacrimal gland will secrete from 0.5 to 0.6g of tears. When you sleep, your eyes are closed and your tear ducts stop working.
• Tears are very beneficial for the human body. In addition to helping to express emotions, tears also help to avoid the invasion of all bacteria, foreign objects ...
• Every time you blink, your eyelids pick up some fluid from your tear glands, which wets and helps clean the cornea. If the cornea is not wetted and cleaned regularly, it will lead to dry eyes . More serious can lead to blindness.

2. Overview of occlusion of the lacrimal gland

Blockage of lacrimal gland is also known as lacrimal gland blockage. It usually occurs when the tear drainage system is partially or completely blocked, causing live tearing, irritation, or chronic infection of the eye.

Obstruction of the lacrimal gland is a fairly common condition

3. Causes of blocked tear ducts in children

Congenital tear duct obstruction

• It is the most common defect of the lacrimal gland.
• About 20% of children have congenital tear duct obstruction, most of which resolve spontaneously by the time the child is 1 year old.
• Usually occurs in newborns because the epithelial cells do not make the ducts to form the nasolacrimal duct when going down the nose.
• The tear drainage system is not fully developed or has an abnormal tube.

Other causes

• Eye infection or inflammation. An infection or inflammation of the eye can cause the drainage of tears or the nose to become blocked. Chronic sinusitis is a case in point, which can irritate scar tissue and clog the tear duct system.
• Abnormal growth of the skull and face or craniofacial abnormality. Down syndrome is an abnormal craniofacial that increases the likelihood of blockage of the tear ducts.
• Children with trauma near the nose or at the nose such as broken nose and scar tissue can block tear ducts. If not treated promptly, the possibility of tear duct blockage is very high.
• Tumors. There are many tumors that cause blockage of the tear ducts, including cysts or stones.
• Nasal polyp : is a piece of excess meat that forms from the nasal mucosa in children with allergic rhinitis in the nasal sinuses, compressing the tear drainage system, causing blockage of the tear glands.
• A side effect of some chemotherapy drugs and radiation therapy for cancer can be blocked tear ducts in children with cancer.

Blocked tear ducts in newborns are difficult to detect because babies often sleep a lot after birth. Only when the baby is a few months old, the symptoms of blocked tear ducts become obvious.

4. Symptoms of blocked tear glands

• The most obvious sign of a blocked tear duct is the continuous flow of tears that cannot be stopped even though the body is not affected. This symptom, if not treated promptly, can lead to eye infections, recurrence of inflammatory diseases and eye infections.
• High-grade infection caused by bacteria accumulating in the lacrimal sac. Signs of an infection:
  • The eyelashes are often covered with scum.
  • Blurred vision and discharge of pus.
  • Redness in the white of the eye and often painful swelling near the inner corner of the eye.
  • Tears can be tinged with blood.
  • In some cases, there may be a fever.
• Children with blocked tear glands are always wet as if they just cried.
• In particular, every morning when I wake up, my eyes often have a lot of yellow rust, stuck around the eyelids.

Eye discharge is often a symptom of a blocked tear duct

5. Subjects at risk of occlusion of the lacrimal gland

• It is most common in infants because the child's tear drainage system may not be fully developed or has an abnormal tube.
• The patient has had previous surgery such as eyelid surgery, nose surgery, bone surgery in the nose ...
• Children with glaucoma (glaucoma) are taking anti-glaucoma medications.
• Children with cancer receiving chemotherapy drugs and radiation therapy.

6. Preventing blocked tear glands

For congenital occlusion of the lacrimal gland in infants, there is no way to prevent it. However, this disease will go away on its own by the time the child is 1 year old. In the case of children with severe blockage of the lacrimal gland, it is necessary to appoint a lacrimal gland for the child.

Prevent infection or inflammation by:

• Limit, preferably avoid contact with patients with conjunctivitis .
• Wash your hands frequently and thoroughly before eating and after using the toilet.
• When feeling itchy or irritated eyes, remind children not to rub or rub their eyes with their hands.
• Limit children wearing contact lenses.
• Stay away from secondhand smoke because secondhand smoke is one of the causes of nasal irritation, especially in children. It aggravates blocked tear ducts in children and makes the infection worse.

Remind when your baby rubs his eyes with his hand

7. Diagnosis of blocked tear glands

• Take medical history, complete eye exam: To assess whether the child's lacrimal duct is blocked or not. If so, find the cause of this disease.
• Fluorescein staining. This is done by injecting a special dye into each eye, after 5 minutes of normal blinking. If there is a significant amount of dye inside the eye, a tear duct is blocked.
• Check the circulation of the tear drainage system. Check by injecting fluid into the child's lacrimal system through the tear point in the inner corner of the affected eye. If the newly pumped fluid does not reach the throat, the patient is diagnosed with a blocked tear duct.
• X-ray or CT scan. When conducting imaging, it is advisable to combine contrast injection into the lacrimal system to help the doctor investigate more deeply and make a more accurate diagnosis.

8. Measures to treat blocked tear glands

Depending on the cause of the disease, the subject of the disease, the doctor will advise and offer different treatment measures for blocked tear ducts.

For infants with congenital tear duct obstruction

• No treatment is needed, it can go away on its own after the child is 1 year old.
• However, with these children, parents need to know how to clean their eyes.

Making:

• Use cotton wool or soft cloth, absorb water, preferably use boiled water to cool, ensure sterility or use physiological saline (eye drops) NaCl 0.9%.
• Gently wipe the baby's eyes, remove all the slime and rust on the baby's eyes.
• Should perform eye hygiene 3-5 times / day to keep the eyes always clean.
• Pay attention to do it very gently and carefully, to avoid scratching the eyelids leading to infection.

Parents need to know how to clean their baby's eyes

If your baby's eyes are red and swollen, you need to take him to an eye specialist for advice and appropriate treatment.

For children over 1 year old

• If the tear ducts are still blocked by 1 year of age, have the child use a special massage technique to help open the membranes. Should massage 2-4 times / day to help the membrane more open.
• For children with blocked tear ducts due to trauma to the face: Doctors will wait a few months to see if the condition improves after the wound heals.
• Insert catheter/stent. This method uses silicone or polyurethane tubes to open narrowing blockages within the tear duct system.
• Dilatation through balloon catheter. This method is used to open areas that are narrow or blocked by scarring and other causes. The intended audience is infants and toddlers.
• Surgery to open the tear sac down to the nose: Indicated for older children with contraindications for catheters. In addition, it is indicated for infants and toddlers with congenital defects in the tear ducts when other methods have not been effective.
• Laparoscopy: This method has many advantages such as no incisions, scars and the recovery process is usually faster and easier. However, it also has limitations such as the low success rate.
• After successful surgery to open the tear duct, it is necessary to use a nasal spray to prevent the inflammatory process after surgery. Spray 2-3 times a day for 2-3 weeks after the procedure.

9. Summary

"Eyes are the window to the soul", therefore, children's eyes need the best care and attention. Obstruction of the lacrimal gland is a common disease. When children have signs such as a lot of rusty eyes, continuous tears, do not worry too much, need to clean and clean gently, regularly and properly. If the condition persists and the symptoms worsen, it is necessary to take the child to see a doctor to find out the cause and timely treatment. Please select information and take care of children properly and intelligently in modern times!

Doctor Doan Thi Hoai Trang