Tear Duct Obstruction in Babies
In infants, tear duct obstruction may be present in 1-3% of newborn infants.
The problem in most of these babies is that there is a membrane-like blockage in the last part of the duct where the tears flow into the nose.
This structure normally opens spontaneously at birth or within a month after birth.
In some babies, there may be swelling in the sac part of the duct where the tear empties, the clogged duct paves the way for infections, and patients often have intense burrs and conjunctivitis findings, in some babies there is a nasal root (tear sac. region) when pressure is applied, there is a discharge towards the eye.
Diagnosis of the disease is made simply by dye test. After the instillation of the dye, ponding on the surface of the eye and not passing into the nose is a sign of obstruction, this test is usually diagnostic.
The treatment of lacrimal duct obstruction in infants is massage until the age of one and the application of antibiotic drops from time to time if there is an infection, where proper massage is of great importance.
Because babies who are properly massaged have a 90% chance of opening the canal.
Massage is based on the principle of pressing the area of the tear sac between the eye and the root of the nose, pushing the liquid in the sac to the lower end of the canal, and thus opening the membrane-shaped blockage at the bottom of the canal.
A hydrostatic pressure is created by pushing the liquid accumulated in the sac to the lower end of the channel.
In cases where the duct is not opened until the age of one year, the treatment is the surgical application of lacrimal duct obstruction, which we call probing. In this process, it is the process of opening the channel with a metal rod that is advanced through the channel to the lower end of the channel.
The success of the procedure is around 90%, the application of the procedure under the tear duct by controlling it with an endoscopic imaging system increases the chance of surgical success.
In unsuccessful cases, the procedure is performed again after 6 weeks. If the result is unsuccessful, the silicone tube is inserted into the canal. The success of these applications in children decreases with age.
Therefore, if the canal is not opened with massage, waiting for the patient to open the canal after one year of age may reduce the success of the surgical applications to be applied later.
How to Do Tear Duct Occlusion Massage in Babies?
In the presence of tear duct obstruction in infants, massage can be applied. The aim of the massage is to convey the liquid in the tear sac to the nasal region and to remove the membranous blockage in the lower part of the nose where the duct is blocked.
Here, it is aimed to transmit the liquid in the sac to the lower part of the nose, to create a hydrostatic pressure here and to open the membrane of the lower part of the channel.
The part that connects our eyes and nose, which we call the pouch area with the thumb of our hand, is removed by pressing this area of the baby with our thumb and waiting for 3-5 seconds.
Tear duct obstruction massage in babies is performed in this way. In this way, a hydrostatic pressure is created and the fluid is transmitted from the sac to the lower part of the nose.
Massage should be done 3 times a day at least 10 times or as often as possible. While doing the massage, care should be taken not to apply serious pressure to damage the bone structure, as the bone structure in the baby's eye is sensitive.
