Tear duct surgery in Nîmes
Tear ducts specialty
Do you often suffer from conjunctivitis and styes, and notice that your eyes sometimes water?
These signs may indicate an obstructed lacrimal duct, i.e. the tear duct leading to the nostril tends to become blocked. It then gradually becomes necessary to perform a lavage with a cannula for several reasons: to push out a mucus plug, to check the effectiveness of a lavage by passing the lavage fluid through the nose, and to diagnose whether the tear duct is clear.
If the lavage is effective, a prescription will prevent you from having to re-clog your tear ducts in the future.
If lavage fails to unblock your tear ducts, antibiotic eye drops will be tried. In the event of further failure, a CT scan of the tear ducts will be performed to determine whether there is any deformity, compression or malformation blocking the tear duct.
In the event of failure 1 week after medical treatment, surgery under general anaesthetic may be decided.
In practice, in cases of more or less chronic tearing in children
Dear patient, Please note the following: the most important thing is to tell parents that chronic tearing is a weakness in children and must be treated with care. If it recurs too frequently at an age when surgery is possible, a dacryocystorhinostomy will be necessary to prevent an abscess and, in the worst case, removal of the lacrimal sac, which is effectively an amputation.The ultimate operation in this case would be an Arnaud-Delord laco-dacryostomy, avoiding the Jones tube, but fortunately we are not at that stage yet.
Preventive treatment must be administered by an ophthalmologist and includesnasal and oculartreatment; one alone is not sufficient, both are necessary. Even the slightest cold or ocular-nasal allergy and obstruction will threaten a child who has narrowed tear ducts or partial obstruction.
Here is what I recommend:
Nasal irrigationwith Physiomer or Dacryoserum, or Stérimar plus, depending on the child's age and tolerance. Rhinomaxil containing a corticosteroid if an inflammatory/allergic component is evident.
Eyewash: Dacudose 4 times a day, applying gentle pressure to the tear sac area to empty it, avoiding persistent moisture that could cause eczema. Ten minutes later, apply antibiotic eye drops while lying down for at least one minute, as the drops only remain in the eye for five minutes, especially if the child (or parents) is/are uncooperative or the child is crying.The antibiotic can be combined with a corticosteroid, administering antibiotic eye drops containing cortisone for a maximum of one week if the situation is serious. Sterdex ointment: 1/2 capsule in each inner corner of the eye if both eyes are infected. Morning and evening for 8 to 10 days, depending on the infection.The ointment lasts longer: 20 minutes in the eye.
What conditions must be met to justify an intervention on the tear ducts?
- watery eyes that interfere with activity
- Stage 1 is simply functional discomfort,
- This is followed by stage 2, causing recurrent infections.
- Then comes stage 3, with its trail of "minor" infections.
- and finally stage 4, a sufficient condition to justify surgery.
Frequently asked questions
Are the lacrimal passages responsible for styes or conjunctivitis?
Poor drainage to the nose causes tears to stagnate in the eye. Microbes are no longer carried into the nose and can infect the 200 glands at the edge of the eyelids, causing styes, chalazia and recurrent conjunctivitis.
Why wash your lacrimal passages?
The serum introduced into the lacrimal point at the inner corner of the eyelids is used to push the thick, sometimes purulent secretions into the nose to be blown out.
Is it painful to wash?
On a scale of 0 to 10, the discomfort caused is rated between 2 and 3, and some patients return every year to avoid a complication.
Can dacryo-cysto-rhino-stomy surgery be avoided?
Yes, if cleansing is effective and there is no tear duct malformation requiring surgery.
Is a dacryo-cysto-rhino-stomy always performed under general anesthesia?
A general anaesthetic is almost always required for patient comfort.
My baby has recurrent conjunctivitis. Do I need to do a catheterization?
Catheterization under local anaesthetic is a fast, effective procedure.
If not, the incovenient of recurrent conjunctivitis is important, with prescription of local and general antibiotics by mouth if an abscess forms.
Failure of local antibiotic treatment requires catheterization.
