Probing for a child. Let's read how probing of the lacrimal canal is done in children under one year old. Reasons for the procedure. Caring for a child after probing

Probing of the lacrimal canal in a newborn is carried out for dacryocystitis. This is a disease associated with a violation of the drainage system of the eye. Due to the lack of normal outflow of tears, they accumulate in the lacrimal sac with the subsequent development of the inflammatory process.

Symptoms of pathology

Signs of the disease are most often observed from birth (primary form). With frequent inflammatory eye diseases, symptoms may appear later due to scarring in the tear ducts (secondary dacryocystitis).

Main symptoms:

constantly wet and reddened conjunctiva of the eye;
lacrimation in the absence of crying;
purulent or mucous discharge from the eyes, often completely filling the palpebral fissure;
swelling of the eyes and eyelids;
there may be a violation of the general condition of the child;
when pressing with a finger in the area of the inner corner of the eye (projection of the lacrimal sac), the amount of discharge increases.

The severity of the signs of the disease varies from mild catarrhal phenomena, reminiscent of conjunctivitis, to severe edema with constant lacrimation and abundant purulent discharge, filling the entire palpebral fissure. General state At the same time, the child’s functioning is disrupted, he becomes restless and whiny.

Dacryocystitis itself does not threaten life or cause significant visual impairment. It is dangerous due to its complications, since infectious process from the lacrimal sac can spread to other structures of the eyes, ears, and sinuses of the facial skull.

Self-healing is possible - the embryonic film that disrupts the patency of the ducts often gradually resolves during the first year of the child’s life. Massage helps restore the patency of tear ducts. Therefore, in the absence of pronounced dacryocystitis, ophthalmologists suggest focusing on conservative treatment until the age of six months. The decision is made by the parents - to wait until this date or to carry out probing.

Diagnostics

If dacryocystitis is suspected, the ophthalmologist, after a thorough survey of the parents and a careful examination of the baby, conducts:

Testing Vesta. A harmless coloring solution is dropped into the eye. If after 20 minutes it is not released through the nose, we can assume obstruction of the tear ducts.
Differential diagnosis with conjunctivitis.

Local anti-inflammatory therapy is carried out. If symptoms persist, the ophthalmologist prescribes a special massage.

Having convinced himself that conservative measures are ineffective, the doctor recommends surgical intervention - probing the lacrimal duct in a newborn.

Indications

The main indications for this procedure are:

clinic of severe dacryocystitis with constant lacrimation and profuse purulent discharge at any age;
the appearance of a convex formation in the area of the inner corner of the eye, resulting from the accumulation of fluid in the lacrimal sac;
child anxiety, sleep and appetite disturbances, frequent eye infections;
suspicion of adhesions after undergoing eye diseases, which cannot be eliminated with massage;
persistence of manifestations of dacryocystitis at the age of 12 months and older.

Preparation

Before the procedure, you must:

examination by a pediatrician;
laboratory examination (blood test, including blood clotting);
consultation with an ENT doctor to rule out a deviated nasal septum and other problems that cause similar symptoms.

How is the procedure done?

Purpose of probing: expansion, cleaning and rinsing disinfectant solutions.

Under general or local anesthesia, a probe pierces the film, which should have disappeared at birth.

Then the patency of the nasolacrimal ducts is carefully checked.

The cleaned channels are washed with disinfectant solutions until full patency is restored. Antiseptics introduced into the canal should be poured out through the nose.

The technique is simple, but, as with any operation, undesirable consequences are possible.

Possible complications

Complications of probing are divided into early and late.

The earliest ones are:

bleeding;
infection;
consequences of anesthesia in the form of an allergic reaction, vomiting, anxiety, impaired consciousness.

Late complications:

development of adhesions;
temporary return of obstructive symptoms to acute period respiratory infections.

Parents should know about this!

How older child, the more often complications and the need for repeated probing.

To prevent complications after surgery, you need to drop it into your eyes for a week. antiseptic solutions, Do massage.

The probing result is monitored after a month. Contrast is injected into the tear duct. If it is not discharged through the nose, massage and antibiotics (drops, ointments, rinses) are prescribed.

After a month of conservative treatment, if there is no result, the manipulation is repeated.

The pediatric ophthalmologist decides which treatment option to resort to and when. The task of parents is not to delay the procedure and carefully follow the doctor’s recommendations in order to prevent dangerous complications. Timely probing of the lacrimal canal in a newborn will restore his health and the quality of life of his parents.

Good day, my readers! Today I want to tell you about how probing of the lacrimal canal is performed in newborns. If you read me regularly, then you already know the causes of blockage of the tear duct. Last time I decided not to touch on the topic of bougienage, but it turned out that many mothers are interested in this topic.

So, eye probing is carried out if the child’s gelatin film does not break through, i.e. neither massage nor rinsing leads to the desired effect, and the eyes continue to constantly water, moisture or even pus accumulates in the corners, the eyelids swell and turn red.

Until now, I myself shuddered at the thought of surgery, but bougienage is more like a procedure, although it requires surgical intervention.

Typically, blockage of the tear duct occurs in small children who are 2-3 months old.

Initially the doctor:

examines the newborn;
take blood clotting tests;
will refer you for a consultation to an otolaryngologist.

When all the tests are collected together, the mother and baby are sent for probing.

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The operation does not last long, taking up to 5 minutes in total. Often the parent is not allowed into the office, but is asked to wait in the corridor (although if you decide to carry out the procedure in paid clinic, most likely you will not be prohibited from attending).

The procedure takes place in a certain sequence:

the newborn is swaddled tightly so that the hands do not interfere with the operation, the nurse holds the head (the mother may be asked to hold the legs);
do the child local anesthesia(a paid clinic may offer anesthesia);
then the child’s tear ducts are expanded using a certain instrument;
then a probe is inserted into the lacrimal canals (hence the name, and the probe itself is a tube that is used to rinse the eye);
At the end, the channels are treated with a solution (for disinfection).

After probing the lacrimal canal, the newborn is prescribed massage and antibacterial drops.

By the way, Dr. Komarovsky told a lot about the blockage of the tear duct, as well as about bougienage itself:

Be responsible post-operative care for your newborn. The doctor immediately warned my friend that if the recommendations are not followed, a relapse is possible.

2. Complications after surgery

And although in most cases the operation proceeds without consequences, there are children who have to undergo repeated probing.

Due to the fact that probing involves penetration into the lacrimal canal foreign body– it is likely that a wound will form on inside eyes. If the scar is not treated and preventative massage is not performed (which is a recommendation after surgery to prevent relapse), the canal may become clogged again. In this case, a repeat procedure will be scheduled.

An important point is the age of contacting a specialist. The sooner you show your child to the doctor, the greater the likelihood that the probing will be easy. With age, the gelatinous film becomes harder and harder, making it much more difficult to break.

As you can see, there is nothing wrong with bougienage, the main thing is to tune in. Do not delay in seeing a doctor; you can overcome the disease initial stages much easier, sometimes a massage is enough.

I forgot to say! My friend’s child was still constantly snoring, they thought it was a peculiarity - it turned out that this was another symptom of obstruction of the tear duct (shhh, they don’t write about this on the Internet!).

3. Reviews from moms

And here is what mothers whose children have undergone a similar operation write.

Valeria:

We have already undergone this operation, in fact everything just goes away, but only my daughter was scared. This is understandable, we went to a regular clinic, waited a week for appointments, and when they arrived, they didn’t even let me into the office!!! My daughter is in shock; some strangers took her away from her mother, wrapped her in a diaper and poked her in the eye with an incomprehensible thing! But everything worked out, the disease never returned, pah-pah.

Masandra:

And I took my daughter to a paid office, everything was civilized, neat, they let me into the office, cleared her eyes in 3 minutes, prescribed eye drops for germs, showed how to do a massage correctly. One minus, the price list doesn’t say that I have to pay extra for a consultation, but I’m still happy.

Katya_Katyushka:

I also took my son, he was five months old at the time. The doctor said that I was delaying it in vain, because the film had become tougher, and it would be more unpleasant for the child than for other children. I did something, but Mityusha now has a scar in his eye, it’s clogged again, apparently I’m doing the massage wrong, or something else. In short, I’m afraid that I’ll have to go for repeat probing again. Although I read that they can still go for some time after the operation. purulent discharge from the eye. I don’t know, I’ll see the doctor again soon.

My dear readers, I realized that our environment (friends, relatives, acquaintances) is a whole storehouse of information! with their own life situations our friends give us precious experience.

While listening to your grandmother’s next story on the bus, think about it: maybe her experience will help you cope with a certain problem. Subscribe to my blog to always stay up to date with all the news. Bye bye!

Probing the lacrimal canal in newborns is considered the last step in the treatment of dacryocystitis. In cases where conservative medicine is powerless, it is recommended to resort to such manipulation. What is its essence, what are the indications and contraindications, as well as other recommendations for caring for a baby’s sore eyes are described in this article.

Obstruction of the lacrimal canal in some newborns is formed in the following way. When the baby is still in the mother's womb, his eyes are protected by the so-called gelatin film, located just in the tear ducts. It prevents amniotic fluid from entering the tear ducts, as well as the nose and Airways.

When a child is born and screams for the first time, the film bursts from tension. In rare cases, this process still does not occur. Due to the fact that it maintains its integrity, there is no opportunity for tears to escape, they accumulate in the lacrimal sac and cause inflammatory process. The described phenomenon is the cause of dacryocystitis.

Symptoms of the disease

with light pressure on the lacrimal sinus, pus flows out of the eye;
continuous flow of tears in any condition of the child or their absolute absence;
pus is released without stimulation.

If these symptoms are present, in order to make a final diagnosis, the doctor resorts to the following manipulations: a special coloring liquid is poured into the child's eye. Before the procedure itself, cotton strands must be placed in the nostrils. You need to wait 5 minutes and let the solution flow down the entire tear duct.

The absence of violations is indicated by colored cotton wool, since normally the liquid overcomes the lacrimal canal and enters the nose. If staining does not occur, the doctor diagnoses obstruction of the canals and prescribes probing of the lacrimal canals. It is worth considering that it is better to carry out intervention for children who are already 2-3 months old, not earlier.

If the situation is urgent and alternative treatment methods have not helped, probing can be done earlier. Parents must definitely find out information about why. Timely implementation of recommendations will help to avoid serious problems with vision.

Indications for probing

inflammation of the tear ducts and sac has acquired chronic status;
alternative treatment methods (drops, massage) do not help;
continuous flow of tears;
the doctor questions the normal development of the lacrimal duct.

If all indicated symptoms are present - probing of the lacrimal canals in infants is inevitable, otherwise dacryocystitis in newborns will lead to more dire consequences, including loss of vision.

Preparing the baby for probing

The operation is performed by a highly qualified pediatric ophthalmologist in a specially equipped eye office or clinic.

5 stages of preparation for the procedure:

The final diagnosis should be confirmed by consultation with an otolaryngologist to ensure that there is no congenital curvature nasal septum.
For rent general analysis blood to check clotting.
A few hours before the operation, it is not allowed to feed the small patient to prevent the possibility of regurgitation during the procedure.
Before the manipulation itself, the baby must be swaddled tightly to eliminate the possibility of chaotic movements of the arms and legs.
It is better for the child to be well-rested and in a good mood.

How the operation is performed

The probing procedure is carried out using local anesthesia and lasts no more than 10 minutes.

The operation is simple and lasts no longer than 10-15 minutes, although parents may find it scary

Drops with an anesthetic effect are dropped into the child's eyes.
The doctor inserts a special sterile instrument called a Sichel probe, which has a conical shape, into the tear ducts.
Thanks to their special shape, the tubules expand.
Then the doctor uses a “Bowman probe”, which, due to its length, is inserted to the required depth and breaks the film.
Next, the tear duct needs to be rinsed generously. saline solution and disinfect special means.
The last step is the manipulation of instilling the coloring solution into the eyes, described above. If the cotton wool in the nose takes on the color of dripped liquid, this indicates a successful operation.

Postoperative care

Probing the lacrimal canal in children under one year of age, although it does not take much time, is considered a micro-operation, after which the patient is entitled to special care. After the procedure, you need to perform the following recommendations:

avoid the possibility of catching a cold or runny nose for several months (to prevent a relapse);
massage of the lacrimal canals for 7 days;
For a week, instill special antibacterial drops into the eyes or apply ointment according to the prescribed dosage.

The table shows commonly prescribed drugs after probing surgery.

Name (release form, volume), age category	Directions for use, dosage	Contraindications	Adverse reactions	Average price, rub.
VITABAKT (drops 0.05%, 10 ml), from birth	IN postoperative period the drug is instilled into conjunctival sac 1 drop 3-4 times/day.		Rarely allergic reactions in the form of conjunctival hyperemia
VIGAMOX (drops 0.5%, 5 ml), from 1 year	Place 1 drop in the affected eye 3 times a day	Increased sensitivity to any of the components of the drug or to other quinolones	Pain, irritation and itching in the eye, dry eye syndrome, conjunctival hyperemia, eye hyperemia
FLOXAL (ointment, 3 g), from birth	1.5 cm strips of ointment are placed behind the lower eyelid of the affected eye 2-3 times a day.	Hypersensitivity to the components of Floxal	Allergic reactions, transient hyperemia of the conjunctiva, burning sensation, discomfort in the eyes, itching and dryness of the conjunctiva, photophobia, lacrimation
LEVOMYCETIN (drops 0.25%, 10 ml), from 1 year	The drug is instilled into the conjunctival sac, 1 drop 3-4 times a day.	Inhibition of hematopoiesis, skin diseases (psoriasis, eczema, fungal diseases), newborn babies, individual intolerance to the drug	Possible development of allergic reactions
TOBREX (drops 0.3%, 5 ml), from birth	The drug is instilled 1-2 drops into the conjunctival sac of the affected eye (or eyes) every 4 hours.	Hypersensitivity to the components of the drug	Allergic reactions
OFLOXACIN (drops 0.3%, 5 ml), from 1 year	The drug is instilled 1 drop into the conjunctival sac of the affected eye 2-4 times a day.	Hypersensitivity to the components of the drug and other quinolone derivatives	Transient burning or discomfort in the eye, conjunctival hyperemia, blurred vision, eye pain, itching sensation

At simultaneous use Vitabact with other ophthalmic drugs, the interval between instillations should be at least 15 minutes.

Long-term use of the antibiotic Vigamox can lead to excessive growth of non-susceptible microorganisms, including fungi. In case of superinfection, it is necessary to discontinue the drug and prescribe adequate therapy.

When using Floxal, there is a condition - when using more than one drug simultaneously, the ointment should be used last.

If the doctor prescribed Levomycetin, it is worth knowing that in newborns the liver is not developed enough to bind chloramphenicol ( active substance drug), so it can accumulate in toxic concentrations and lead to the development of “gray syndrome”. In the first months of life, drops are prescribed only vital signs, at severe cases dacryocystitis in infants.

T obrex - antibiotic wide range actions from the group of aminoglycosides. Long-term use of these eye drops, as with the use of other antibiotics, can lead to increased growth of resistant microorganisms (also fungi). It is recommended to do cultures before and after the end of treatment if the clinical result is unsatisfactory.

About floxacin - effective drops with dacryocystitis of newborns. Although there is no data on overdose, if an excess dose of the drug is used, the eyes should be washed clean water room temperature.

Possible consequences of the procedure

Compliance with all doctor’s instructions regarding eye hygiene is very important to avoid relapse

Since sensing falls into the category surgical interventions, this procedure can have a number of complications. A common undesirable consequence is scarring, which forms at the site of puncture of the lacrimal canal. In this case, the likelihood of re-clogging the duct increases.

Less commonly, an individual reaction may occur small organism on local anesthesia. To minimize the likelihood of unexpected consequences after surgery, you should carefully prepare for it, as well as strictly follow absolutely all the doctor’s instructions.

When may repeated surgical intervention be necessary?

Almost 100% of the performed probing operations on the lacrimal canal are completed successfully and the desired effect is achieved. It happens very rarely that the condition of a small patient does not improve. In this case, the child is observed for a month and then sent back for the procedure.
There is no effect from probing for the following reasons:

initially misdiagnosis(the problem is not acute dacryocystitis);
the probe penetrated to a shallow depth without reaching the film;
After the operation, a scar formed, which re-clogged the duct and caused inflammation.

If improvement does not occur for one of the last two reasons, it makes sense to re-probe the lacrimal canal.

Contraindications for surgery

There are 2 reasons for refusing surgery:

deviated nasal septum;
acute purulent inflammation of the lacrimal sac and surrounding tissues (phlegmon).

If the child was born with an already deviated nasal septum or has congenital anomalies in the structure of the lacrimal canals - probing simply does not make sense, since other surgical interventions are needed.

In these cases, it is undesirable to perform the procedure, since the course of the operation may be unplanned and the consequences may be disastrous. But, nevertheless, in some cases, doctors still perform the operation with contraindications, since each case is individual. If at purulent inflammation try to probe - you can aggravate the situation even more.

Alternative treatments without probing

When initially dealing with the problem of congenital dacryocystitis in a newborn, a doctor usually prescribes more conservative treatment:

special massage;
eye wash;
instillation of drops.

The implementation of these recommendations in combination prevents probing surgery in 80 out of 100 cases. If manipulation alternative treatment dacryocystitis in newborns did not give the desired result - it is prescribed surgical intervention.

Regarding massage, it is worth clarifying that it belongs to the class of therapeutic, so before performing it, you should definitely ask your doctor about the technique, frequency, and duration of its implementation.

There are several general rules performing massage on newborns with dacryocystitis:

Hands must be washed thoroughly and wiped dry. and file to avoid unwanted injury to the delicate skin or mucous membrane of the eye.
Massage movements It is recommended to perform it with the little finger, in a circular motion.
- After the massage, rinse the child’s eyes and remove all discharge from the eyes. You can wash your eyes with chamomile infusion prepared at home, tea leaves or furatsilin solution. The liquid should be at room temperature and freshly prepared each time. More information about how to wash the eyes of a newborn is described in a separate section.
Apply drops to the conjunctiva with special eye drops antibacterial drops. It is advisable that this stage taken just before bedtime - then the effect of the drug will be better.

conclusions

Probing the lacrimal canal in newborns is a serious procedure, but it also has positive sides: speed of implementation, painlessness for a small patient, low price. When there is a need to carry it out, it is better not to hesitate, but to speed up the onset of a happy moment for the baby.

This procedure is a fairly safe operation, but it is still worth taking a closer look at it and finding out why it is dangerous, because there are other methods of treatment.

Problems with the tear duct from birth arise due to the fact that the film that protected the baby’s eyes in the womb did not break during his first cries, so the fluid began to accumulate and suppuration formed.

Indications for probing

It is a fairly normal thing for newborns to develop some eye problems. The reason for this can be hidden in many things, be it allergies, infection or problems with the tear duct. Sometimes the symptoms are revealed in the maternity hospital: lacrimation, redness, discharge of purulent masses, souring of the eyelids. But, most often, the cause of all this is conjunctivitis, which can be treated with simple rinsing and some medications.

But if this is not the reason, then most likely it’s all in the child’s lacrimal duct. To find out the diagnosis, you need to contact a pediatric ophthalmologist, who can easily determine the cause and prescribe the appropriate treatment. As a rule, probing of the lacrimal canal in newborns is prescribed.

Checking for problems with the tear duct is carried out as follows. The doctor drops a harmless solution, colored in a noticeable color, into the baby's eye, after which a cotton swab is inserted into the baby's nose. If there are no problems, the tampon will turn the color of the solution, otherwise there is a blockage, so you will have to treat it with probing.

Video: Obstruction of the tear duct

Aznauryan Igor Erikovich, MD, pediatric eye surgeon, pediatric ophthalmologist, head of a specialized system of children's eye clinics.

Risks

In fact, the procedure is quite safe, because everything is carried out under anesthesia; all you need to do is take care of the child after the operation, that is, do not forget about massages, drips of antibacterial drugs and monitor the condition of the eyes. Parents can also choose a more experienced attending physician so that he definitely does not misfire.

If the child catches a cold in the near future after the operation, then the suppuration will recur, otherwise there are practically no relapses. Therefore, eye probing in newborns is considered the most effective, fastest and safest method.

Carrying out the procedure

Some people don’t know how to probe the lacrimal canal in newborns, so it’s worth talking about it in more detail. So, the beginning of the whole procedure begins with a visit to an otolaryngologist, who will give an accurate diagnosis, because similar symptoms can be observed in other diseases. The attending physician advises trying to get rid of the problem using improvised methods, this is a massage; if it works, the gelatin plug will break through on its own, and no operation will be necessary.

But if the operation is still planned, then before probing, blood is donated to determine its coagulability, everything takes place under anesthesia. The procedure is performed by a doctor who puts on gloves and takes instruments. The head is fixed in one position so that nothing happens during insertion of the probe. Now is the time to open the eye and instill painkillers. Next, the film is pierced with a tool and washed with an antiseptic. This action will take no more than five minutes. This is how this operation is performed.

Balasanyan Victoria Olegovna, PhD, deputy head of the specialized system of children's eye clinics.

Consequences of probing

After the procedure, the baby can go home with his parents, who must monitor the condition of the baby’s eyes for two months. The fact is that sometimes eye probing does not help due to insufficient depth or incorrect diagnosis, but this happens very rarely. But if, nevertheless, the situation turns out in such a way that you will have to consult a doctor again, who will either prescribe repeated probing or another way to solve the problem.

After probing, if the operation was successful, then after a few hours the result will be noticeable, because the eye will no longer show signs of the disease. But to prevent any infections from getting into the eye, it is necessary to instill antibacterial devices for some time. If you don’t want any recurring problems to arise, then do massage to get rid of all the partitions.

Alternative to probing

As mentioned above, doctors sometimes advise massaging the baby’s eyes before surgery, because sometimes this method works and allows you to refuse intervention. The goal is to try to break through the film, which will be removed using a probe.

How is massage performed:

the accumulated moisture is carefully squeezed out of the lacrimal sac;
a heated, warm furatsilin solution is instilled into the eye;
pus is removed with a cotton swab;
after this you can begin the massage itself;
Once the massage is completed, a disinfectant solution is instilled into the eye.

This procedure can be performed up to five times a day; the massage itself consists of light pushing movements. During a consultation with a doctor about solving problems, try to inquire about how the massage is performed, because it is the specialist who will be able to accurately tell you and show you this procedure. The procedure is carried out only at those moments when the child is crying, because the chance of tearing the film increases. Every movement must be calculated and done as carefully and carefully as possible so as not to harm the baby.

Video: Probing the nasolacrimal duct

A very important note is that the sooner you perform the operation, the less painful it will be for the child, because during the growth of the body, the very film that prevents tears from flowing out strengthens. So if you notice this problem in a child, then immediately go to a specialist who will prescribe treatment and tell you about all aspects, try to find out as much information as possible from the doctor.

Monitor your baby carefully to ensure that pus does not leak into the other eye or ear before surgery. So to the question “How to avoid complications?” everything is simple: the sooner the probing is carried out, the better.

After the operation, a massage is prescribed, which is aimed at removing the remaining walls of the membrane.

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 the period intrauterine 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

Lacrimal organs are an important component 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 normally drain away from 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 - medical term, denoting 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 fluid, 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 special tool 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. 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 acute purulent process in the area of the lacrimal sac (dacryocystitis). In this case, the procedure is carried out only after the symptoms subside against the background antibacterial 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, they are prescribed antibacterial drugs 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.