DOI: https://doi.org/10.22141/2309-8147.6.3.2018.165208

Canaliculitis: problems of diagnosis and treatment

L.P. Tutchenko, E.M. Tchernyak, I.M. Petrenko

Abstract


Canaliculitis is a rare inflammation of the proximal lacrimal drainage system that is frequently misdiagnosed, because canaliculitis can mimic many other common ocular conditions. It classically presents with symptoms of unilateral epiphora, conjunctivitis, mucopurulent discharge, swollen eyelid, medial canthus inflammation, and a red, swollen and pouting punctum with mucopurulent discharge. Time between the first symptoms and correct diagnosis has known to be from 2 days to 20 years. Along with the literature review of canaliculitis, the article analyzes the complaints, clinical presentations and the results of the treatment in thirteen patients. Prolonged duration and polymorphism of the canaliculitis are noted. The effectiveness of using 0.01% myramistin and 2% bibroсathol ointment combined with the canaliculotomy and curettage followed by application of iodine solutions and the repeated lacrimal irrigations in the postoperative period has been shown. The importance of long-term observation and repeated lacrimal irrigations in the postoperative period with curative and diagnostic purposes has been noted. Being caused by the commensal flora of conjunctiva and oropharynx, canaliculitis mainly manifests in immunologically depressed patients. Preventive measures, such as limitation of uncontrolled prolonged use of immunosuppressants, antiseptic and antibacterial agents in the treatment of superficial eye diseases, may reduce occurrence of canaliculitis. Improvement of dental and nasopharyngeal hygiene can prevent the inflammation and optimize the treatment of lacrimal ducts.

Keywords


lacrimal ducts; canaliculitis; dacryolith; myramistin; bibroсathol; canaliculotomy

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