How to treat chronic dacryocystitis

  Pus flowing from the corner of the eye is medically called chronic dacryocystitis, which is a common eye disease in ophthalmology. There is a duct between the corner of the eye and the nasal cavity called the lacrimal duct, which is composed of the tear dots, tear ducts, common lacrimal duct, tear sac, and nasolacrimal duct from top to bottom, and its function is to drain the tears. The tear secretion in adults, except for moistening the eye and partial evaporation, the remaining tears are diverted by the tear duct into the nasal cavity. If the nasolacrimal duct or tear sac is blocked due to inflammation, trauma, foreign body, etc., the drainage of tears is blocked and a large amount of tears accumulate in the tear sac, which, over time, will cause a large number of bacteria to grow and become pus, and then the symptoms of pus flowing from the corner of the eye. Because this disease generally does not have pain, skin redness and other uncomfortable symptoms, and does not affect vision, so it is easy to be ignored, many patients fail to timely treatment or long-term failure to get treatment, in fact, this is extremely dangerous, because the pus-filled tear sac is like a bacterial reservoir, bacteria with the pus will be discharged at any time, infecting the eye, which may cause irreparable damage.  Chronic dacryocystitis is a great threat to eye surgery such as cataract surgery, glaucoma surgery, myopia surgery, etc. It can cause serious infection after surgery, so such patients must be cured of chronic dacryocystitis before they can do the above surgery. Moreover, chronic dacryocystitis may attack acutely, causing inflammation of the tissues around the dacryocyst, local skin pain, redness, swelling, and even generalized fever and discomfort. In severe cases, the tear sac abscess will form a “tear sac fistula” when it breaks through the skin, and this fistula flows pus for a long time and cannot heal on its own, making it difficult to heal completely.  Chronic dacryocystitis is poorly treated with medication alone, and cannot be cured without solving the problem of tear duct obstruction. Previously, the main method of treatment for this disease was lacrimal duct exploration and irrigation, thread retention, combined with drug therapy, but the results were not satisfactory. The next treatment is surgery, which can be performed by lacrimal sac nasal anastomosis or lacrimal sac removal. Lacrimal sac removal is generally only suitable for older and weaker patients who cannot tolerate lacrimal sac nasal anastomosis, and the symptoms of pus flowing from the corner of the eye can be eliminated after surgery, but the symptoms of lacrimal flow cannot be improved. Tear sac nasal anastomosis is relatively effective, but because the surgery requires a 2 cm long incision in the skin of the inner corner of the eye and a hole the size of a penny in the nasal bone, it is not only traumatic but also leaves scars on the face, which affects the beauty, which makes many patients and their families afraid of the surgery, and the cost of the surgery is relatively high. Nowadays, the better treatment method is laser treatment and artificial tear duct placement. The laser lacrimal duct shaping combined with artificial tear duct implantation is a new ophthalmology technique that has gradually emerged in recent years, which uses a YAG laser to open up the lacrimal duct obstruction and place an artificial tear duct to induce lacrimal duct shaping, lift the lacrimal duct obstruction, stop the flow of pus from the corner of the eye, restore patency, and achieve the purpose of treatment. This procedure has the advantages of less trauma, no side effects, no scars, strong patient tolerance, and low cost, etc. It has been gradually recognized by ophthalmologists and patients. However, this surgery is adapted to early chronic dacryocystitis, for recurrent dacryocystitis Tao Hai, director of the department, suggests that lacrimal sac nasal anastomosis is still a kind of surgery to completely solve the flow of pus, the department now applies anastomosis suspension on the orbicularis oculi muscle, the skin surface application of cosmetic suture method, with the advantages of small scar and complete treatment.