Ophthalmology

Inflamed tear duct

introduction

The tear duct is a structure that extends from the inner corner of the eyelid to the nose and allows tear fluid to drain into the nose.

This tear duct can become infected. Often this happens through an obstruction of the drainage of the tear fluid. The drainage can be disrupted by various reasons, for example by structures that obstruct the tear duct.

The tear fluid is formed in the lacrimal gland, which is located at the top outside of the eye. From here the tear fluid reaches the surface of the eye, where it protects the eye from dehydration and the penetration of pathogens. With the help of the blink of an eye, the tear fluid is transported over the entire surface of the eye to the inner corner of the eyelid. Here the tear fluid drains through the tear duct into the nose.

In the case of an inflamed tear duct, a distinction is made between an acute and a chronic form, which is characterized by a longer-lasting inflammation.In both cases it makes sense to consult an ophthalmologist who can initiate the correct treatment after the diagnosis.

What are the symptoms of an inflamed tear duct?

In the case of an inflamed tear duct, a distinction is made between an acute form and a chronic form, which, however, can be represented by similar symptoms.

Patients with an acutely inflamed tear duct often suffer from pronounced swelling, redness and overheating of the inner corner of the eyelid and severe pain in the affected eye.

There may also be itching, which can lead to constant rubbing of the eye.

There is often a secretion of purulent secretion when pressure is applied to the inner corner of the eyelid, as well as the formation of purulent crusts.

The occurrence of a slight to high fever, a pronounced feeling of illness, as well as tender and swollen lymph nodes can also occur.

As a complication, the inflammation can spread to the surrounding soft tissues, which is then known as phlegmon.

Another complication is the formation of an abscess. This is a collection of pus in a new cavity formed by the inflammation. The phlegmon and abscess trigger a strong inflammatory reaction and can be accompanied by massive pain. In both cases it is a very dangerous clinical picture.

If the inflamed tear duct is based on a disruption in the tear fluid drainage system, additional symptoms such as constant tearing can occur. If too much tear fluid accumulates, tear fluid overflows over the edge of the eyelid, which leads to tears (Epiphora) referred to as.

The chronic form, i.e. an inflammation that has existed for a long time, can present itself with similar symptoms. In contrast to the acute form, the chronic form is less often associated with pain.

Pain in the inflamed tear duct

As a rule, acute inflammation of the tear duct is also accompanied by pain. The symptoms are similar to the pain that occurs with conjunctivitis or corneal inflammation.

If there is chronic inflammation of the lacrimal ducts, e.g. Due to tear duct stenosis, this is usually less painful than the condition of acute inflammation. The use of pain relievers is also recommended to treat the inflammation.

You can also find out more at: Pain in the inner corner of the eye

How is an inflamed tear duct treated?

The therapy of the inflamed tear duct depends on the cause.

In acute situations, antibiotics as well as pain relievers and anti-inflammatory drugs are used in particular.

Antibiotics can be applied locally, for example in the form of eye drops. However, if the inflammation is pronounced, oral administration of the antibiotic is preferred.

In addition, cooling and disinfecting compresses can be used on the affected eye, as they often provide pain relief.

If the lacrimal canal is severely swollen, a relieving stab incision can also be performed. With a stab incision, the skin is cut over the swelling, which allows purulent secretion to drain away. A small tube (a so-called drainage) is then inserted, if necessary, which allows purulent secretion to drain off over the long term.

After the acute treatment of the inflamed tear duct, the focus is on treating the underlying disease. If the inflamed tear duct is based on an obstruction of the outflow of tear fluid, it is important to remove this obstacle in order to prevent a renewed infection of the tear duct. If the obstacle is in the tear duct itself, an attempt can be made to open the tear duct with the help of positive pressure irrigation, a probe or an operation.

Structures that move from the nose to the tear duct, such as polyps or tumors, can be removed endoscopically or surgically.

The possible complications of phlegmon and abscess (see section "Symptoms") should also be adequately treated in the form of a combination of antibiotics and surgical treatment, since these are extremely dangerous clinical pictures.

Which home remedies can help with inflamed tear ducts?

Home remedies can be useful for inflammation of the tear duct, but should be used with a doctor's advice to prevent complications.

Envelopes soaked in chilled chamomile tea, or
Eye washes with cold black tea as well
Eye drops with euphrasia (eyebright) can help.
If you have cold symptoms at the same time, both the eyes and the nose can be rinsed with Emser salt several times a day.
From homeopathy, Silicea D12 Globuli can be used for tear duct inflammation.
The use of the Schüssler salts No. 9 (sodium phosphoricum) and
No. 12 (Calcium Sulfuricum) can be helpful for blocked tear ducts.

In the event of an additional fever, general symptoms of illness or visible pus leakage, the ophthalmologist should definitely be consulted. If the tear duct inflammation occurs repeatedly in babies or small children, a visit to the doctor is also recommended.

Learn more at: Schüssler salts - effect and application

What are the causes of an inflamed tear duct?

Most of the time, an inflammation of the tear duct is caused by an obstruction of the flow of tear fluid into the nose.

Reasons for this are, for example, injuries to the tear duct or structures that compress the tear duct. These can either lie in the tear duct itself, or move from the nose out of the tear duct. These include polyps and tumors, among others.

A congenital closure of the tear duct due to tissue that has not completely receded, a so-called tear duct stenosis, can also lead to a disruption of the outflow of tear fluid.

If the tear fluid cannot drain away, it comes to a standstill in the tear duct, which promotes colonization with bacteria, viruses or fungi.

Existing infections of the eye, such as conjunctivitis or inflammation of the lid margin (stye), can also spread to the tear duct and cause inflammation there.

So-called systemic infections that affect the entire body, such as scarlet fever or measles, can also lead to an inflamed tear duct.

Why is the tear duct inflamed so often in babies?

Tear duct narrowing is quite common in newborns. This is also known as lacrimal stenosis and can be congenital or acquired.

The reason for a congenital tear duct stenosis is usually a remaining membrane inside the tear duct that should actually be dissolved at birth. This membrane then hinders the proper drainage of the tear fluid. This phenomenon is common among babies and is known as the Hasner valve misalignment. Over time, however, the tear ducts open completely, so that the risk of inflammation decreases again.

Acquired tear duct stenosis often occurs after an inflammation of the lacrimal sac (Dacryocystitis) on. It is the most common eye disease in newborns. The tissue is softened by the build-up of the tear fluid and bacteria or fungi can penetrate and lead to infection of the tear duct.

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Inflammation of the lacrimal gland
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Cold as a cause

A runny nose usually occurs with a simple infection of the upper respiratory tract, which manifests itself as a blocked and runny nose and the urge to sneeze. The symptoms can also affect the eyes, as there is an anatomical connection between the nasopharynx and the tear duct.

Contact lens wearers can also observe this. If you have a cold, wearing the contact lenses is often uncomfortable because the necessary tear film is missing or the tear duct has become infected.

Sinus infection as the cause

Since there is a connection to the nose through the tear duct, inflammation in the area of the nose can also rise to the tear sac. If the cold goes on for a long time, it can lead to sinusitis (Sinusitis) come. The paranasal sinuses are connected to the nasal cavity via a small opening so that the infection can find its way through the tear duct to the eye.

Also, in adults, tear duct inflammation is sometimes caused by a nasal stone (Rhinolite) caused by chronic inflammation of the nasal mucous membrane or sinus infections. Sometimes the rhinolith occurs directly in the tear duct and thus causes its irritation and inflammation.

How contagious is lacrimal duct infection?

Bacterial or viral eye infections are usually contagious. Therefore you should touch the affected eyes as little as possible and wash your hands regularly. In principle, the same applies to inflammation of the tear duct.

Often only one eye is initially affected by the inflammation of the tear duct. Rubbing the eyes or using cosmetics can also infect the other side.

It is therefore best not to put on make-up or use contact lenses if there is inflammation of the eye or the tear duct. In addition, eye drops should not be saved for further use once the inflammation has subsided to avoid re-infection.

Lacrimal duct inflammation complications

An acute inflammation of the tear duct can, if left untreated, lead to the encapsulation of the inflammation. An abscess then forms, which is always associated with a meltdown of tissue and must be surgically opened so that the pus can drain off. Significant swelling, reddening, warming and fever are characteristic.

The facial phlegmon is also a possible complication of tear duct inflammation. In contrast to the abscess, the pus spreads through the soft tissue without barriers. The swelling appears less plump. However, the course of the disease can quickly become extremely serious.

Read more on the topic: Phlegmon

Therefore, it makes sense not to experiment with home remedies for too long, but rather to seek medical advice in good time and, if the antibiotic is prescribed, to take this until the end of the pack, even if the symptoms have already improved.

Tumors, cysts or scarring should be excluded in the case of regularly recurring tear duct infections.

How is an inflamed tear duct diagnosed?

In order to diagnose an inflamed tear duct, a careful questioning of the patient's symptoms (anamnesis), as well as an ophthalmological examination, which includes a close look at the lids, lacrimal spots and conjunctiva of the affected eye, are essential.

The diagnosis can usually be made on the basis of the classic symptoms such as redness, swelling, painfulness of the inner corner of the eyelid and the discharge of purulent secretions.

Once the inflammation of the tear duct has subsided, it is advisable to use various examination methods to find out the underlying cause, for example a disruption in the tear fluid drainage system.

Some imaging methods such as ultrasound, X-rays, computed tomography (CT) or magnetic resonance tomography (MRT) can be used to visualize the tear duct. In some cases, an examination by an ENT doctor is required, who can use an endoscopy (mirroring) to show structures of the nose.

How can you prevent an inflamed tear duct?

To prevent inflammation of the tear duct, it is important to eliminate potential causes early on.

Since the underlying cause is often an obstruction to the outflow of tear fluid, tear duct stenoses, polyps or tumors that obstruct the tear duct should be treated and, if necessary, removed surgically.

In some cases, the cause of an inflamed tear duct is the spread of conjunctivitis or inflammation of the eyelid margin (stye) to the tear duct. Therefore, if there is an existing conjunctivitis or inflammation of the eyelid margin, rubbing the affected eye should be avoided in order not to introduce germs into the tear duct.

What is the prognosis for an inflamed tear duct?

The prognosis of the inflamed tear duct depends on its cause and the underlying disease of the person concerned.

In many cases, adequate treatment of the inflamed tear duct with antibiotics can cure it.

It is important to avoid complications (phlegmon and abscess, see above) through early treatment, since these can be extremely dangerous clinical pictures.