What is Сanaliculitis in Сhildren?
Canaliculitis is an inflammation of the lacrimal tubules of the eye.
Causes of Canaliculitis in Children
The causes of canaliculitis in children are various diseases of the eyelids, lacrimal sac and conjunctiva. Purulent bacteria, viruses and parasitic fungi are capable of causing the disease. Among parasitic fungi, penicillas, aspergillus, actinomycetes, and trichophytons most often cause this disease. There are a large number of causes of the disease in question, therefore it is called polyetiological.
There is a likelihood of developing a chronic form of the disease if antibiotic therapy of the acute inflammatory process of the lacrimal tubules and conjunctiva is insufficient, ineffective. The following diseases can lead to chronic inflammation of the lacrimal tubules: syphilis, tuberculosis, chlamydial lesions with trachoma.
At an external examination, it is impossible to clearly say what exactly caused the canaliculitis in the child. No symptoms clearly indicate the pathogen.
Symptoms of Canaliculitis in Children
The most striking symptoms of the disease are lacrimation and lacrimation. Parents can notice lacrimation themselves – the child’s eyes seem to be “flooded” with tears that do not go anywhere. In the area of the tubules, there is swelling and hyperemia of the skin, with palpation there are painful sensations.
Fix the expansion of the lacrimal openings, due to hyperemia and swelling. If you press on them, you can see mucopurulent or tiny (if the disease is caused by fungi) discharge.
Diagnosis of Canaliculitis in Children
Doctors recognize canaliculitis in a child by typical symptoms and on the basis of anamnesis. To clarify the cause of the disease, a microbiological examination is necessary.
Canaliculitis Treatment in Children
The contents of the lacrimal tubules should be removed by pressing on the area of the lacrimal tubules, and then the conjunctival cavity is rinsed with antiseptic solutions – the procedure is performed from 3 to 4 times a day. Antiseptics such as solutions of furacilin or potassium permanganate are used.
If canaliculitis in children is bacterial in nature, for several days every 2-4 hours you need to bury the drugs in the conjunctival sac. As soon as the inflammatory process gradually “comes to naught”, the procedure is carried out 3-6 times a day (course 1-2 weeks). Such solutions are suitable:
- picloxidine 0.05%,
- sulfacyl sodium 10-20%,
- miramistine 0.01%,
- gentamicin 0.3%,
- chloramphenicol 0.25%,
- chloramphenicol / colistimethate / roletetracycline,
- ciprofloxacin 0.3%,
- polymyxin B / trimethoprim.
Also, for the treatment of canaliculitis in a child, such antibacterial ointments are laid in the conjunctival sac before bedtime:
- tetracycline 1%
- erythromycin 1%
- ofloxacin 0.3%
- tobramycin 0.3%
- colbiocin (chloramphenicol / colistimethate / roletetracycline)
In the treatment of mycotic canaliculitis 3-4 times a day, solutions that prepare ex temporae should be dripped into the conjunctival cavity, for example, a solution of amphotericin B 3-8 mg / ml. And at night, ointments are placed in the conjunctival sac (also prepared ex temporae), for example, nystatin ointment 100 000 IU / ml.
Treatment of viral canaliculitis requires instillation of antimetabolite solutions in combination with interferon and interferonogen solutions in the conjunctival sac. Two or three times a day in the conjunctival sac, it is necessary to lay antiviral drugs, such as oxalin ointment 0.25%, acyclovir ointment 3%, etc.
In severe canaliculitis in children, dissection of the lacrimal tubule and curettage of its contents is required. And then the wound surface is treated with 1-2% alcohol solution of iodine. If there is stenosis of the tubules, it is necessary to rinse with a solution of collalysine 100 IU / ml of the tear ducts.
Evaluation of the effectiveness of the treatment of canaliculitis
If the diagnosis and treatment are carried out in time, the child completely recovers. But inflammation of the lacrimal tubules can become chronic, which will lead to a violation of the outflow of tears.
Errors and unreasonable appointments
Doctors may mistakenly prescribe antibacterial drugs to treat viral or fungal canaliculitis. This can happen if the nature of the disease is not ascertained by microbiological research. There may also be an error in the regimen of the use of drugs. Frequent instillations of eye drops can reduce treatment time and reduce the risk of developing chronic forms and cicatricial changes.
Canaliculitis Prevention in Children
Preventive measures are quite simple. A thorough regular hygienic treatment of the eye is required. Therapy of purulent processes should be timely and adequate. It is very important to conduct constant medical monitoring of the eye condition.
If you notice suspicious symptoms in a child, do not self-medicate. Differential diagnosis of eye diseases is complicated, additional studies may be required, and self-administration of the wrong drugs to a child can cause complications, which can then be treated for a long and expensive time. Take care of your health and the health of your children!