Fig. 1. Lacrimal organs: 1 - tear points; 2 - lacrimal gland; 3 - the lacrimal sac; 4 - lacrimal-nasal canal; 5 - opening of the lacrimal duct; 6 - the lower nasal sink.
The lacrimal organs are a system of organs that secretes and removes tear fluid that moisturizes the surface of the eyeball and the conjunctiva (Fig. 1). Two departments are included in the lacrimal organs: tears producing and tearing. The first is the lacrimal gland, located in the upper-outer part of the orbit. Its excretory ducts 4-5 open holes in the upper conjunctival fornix. The lacrimal system begins with tear points (upper and lower), which pass into the lacrimal canaliculi, which fall into the lacrimal sac, located at the inner wall of the orbit. The lacrimal sac passes into the lacrimal-nasal canal, ending under the inferior nasal concha.Go
When examining the lacrimal organs pay attention to the lacrimal punctures (narrowing, fusion), their position (inversion, displacement), to the region of the lacrimal sac (swelling, fistula). In pathological processes, the lacrimal tubule is felt in the form of a thickened cord (dacrycanaliculitis). The appearance of discharge with pressure on the region of the lacrimal SAC occurs with inflammation of the lacrimal SAC (dacryocystitis).
Special studies of the lacrimal ducts include tubular and nasal samples, washing, probing, and X-ray of the lacrimal ducts.
The most common causes of lacrimation are: reversal of the lower lacrimal points, narrowing them, incorrect position, narrowing of the tear ducts. The treatment is mainly surgical. In dacryocanaliculitis, treatment depends on the nature of the process (trachomatous, fungal, purulent).
Fig. 2. Edema of the lacrimal sac
Inflammation of the lacrimal sac may be chronic or acute. Chronic dacryocystitis usually develops with narrowing of the lacrimal-nasal canal. The disease is manifested by tearing and discharge of pus from tear points. Due to the constant infection of the mucous membrane of the eyelids, its hyperemia occurs, persistent blepharitis (see) and conjunctivitis (see). There is a risk of a corneal ulcer if it is damaged. With a prolonged inflammatory process, the lacrimal sac expands and bulges under the skin. Further, the entrance to the lacrimal canaliculi is sometimes closed and a closed cavity with mucous contents is formed - the dropsy of the lacrimal sac (Fig. 2). Treatment is surgical (see Dacryocystorhinostomy).Go
Acute phlegmonous dacryocystitis usually develops from chronic infection due to the penetration of the infection from the lacrimal sac into the surrounding tissue. Treatment in the acute period is common (antibiotics, sulfonamides), sometimes an incision of the abscess is made. Dacryocystitis of the newborn develops in cases when, at the time of the birth of the child, the lower section of the lacrimal-nasal canal is closed by an epithelial plug. The treatment is a downward massage or a gentle flushing of the tear ducts.
Fig. 3. Inflammation of the lacrimal gland.
Inflammation of the lacrimal gland (dacryoaderite, Fig. 3) is acute and chronic. Acute dacryadenitis occurs more often as a result of endogenous infection ( sore throat , flu, rheumatism ). Chronic dacryadenitis develops from acute or occurs independently. In the latter case, it is more often of tubercular origin. Treatment of acute dacryadenitis is the local application of heat, UHF-therapy . Inside antibiotics or sulfonamides. When an abscess is formed, it is opened.
Reflex hyperfunction of the lacrimal gland can be the cause of tearing.
Hypofunction of the lacrimal gland is characterized by a sharp decrease in the discharge of tears. At the same time, patients appear complaints of dryness, itching, burning, sensation of a foreign body over the centuries, photophobia . The cornea is affected. Symptomatic treatment.