Dacryocystitis
As dacryocystitis ( gr. Dakry-, tear; zyst-, bladder; itis, inflammation; "sac inflammation") is an acute or chronic inflammation of the lacrimal sac ( lacrimal sac ;) and the surrounding tissue. It is usually caused by an occlusion and subsequent infection of the tear sac (or tear duct , ductus nasolacrimalis ). The disease occurs in humans and animals (more common in domestic rabbits and chinchillas ).
causes
The most common cause of dacryocystitis is a drainage disorder of the draining tear ducts, which leads to a colonization by bacteria (in particular Staphylococcus aureus and Haemophilus influenzae , in rare cases also a primary complex of tuberculosis ). Subsequently, the inflammation ( empyema ), which was initially limited to the tear sac, is transferred to the neighboring tissue ( abscess ).
Dacryocystitis can occur in combination with other symptoms as part of syndromes , e.g. B. in Günal-Seber-Başaran syndrome .
Pasteurella and staphylococci are particularly involved in rabbits . Misaligned teeth are a predisposing factor as the roots of the teeth can narrow the tear duct.
Symptoms
Symptoms of dacryocystitis are painful reddening and swelling of the lacrimal sac area on the affected side and pus emptying from the lacrimal sac through the tear points or through spontaneous opening of the tissue inflammation. Depending on the severity, the eye itself may also be reddened.
In the run-up to the inflammation, the drainage disorder leads to tears ( epiphora ).
treatment
human
The treatment is carried out with antibiotics and disinfecting , moist compresses. If an abscess is present, it must be opened through an incision, since prolonging the inflammation can lead to potentially life-threatening encephalitis .
After the inflammation subsides, the obstruction of the tear duct as the underlying cause of the inflammation must be surgically repaired so that the tears can flow away again and thus prevent renewed inflammation. The procedure is called dacryocystorhinostomy (toti operation). A detour ( bypass ) from the tear sac to the nose is created through a bone window to the nose, through which the tear fluid can drain.
Newer, less reliable methods try to restore the old anatomical relationships with an endoscope.
Rabbits
In rabbits, the lacrimal ducts are usually rinsed under local anesthesia and then an antibiotic is placed in the bags under the eyes. Here are gentamicin and enrofloxacin proven. Also in rabbits must be recurrences are expected. Often the obstruction of the tear nasal canal in rabbits is based on a change in the roots of the teeth in the upper jaw, which can be determined with the help of x-rays. If the teeth are misaligned, these must be corrected.
See also
Individual evidence
- ^ Franz Grehn: Ophthalmology. 30th, revised and updated edition. Springer, Heidelberg 2008, ISBN 978-3-540-75264-6 , p. 76.