Inflammation of the lacrimal gland is also called dacryoadenitis. This disease can be caused by both mechanical and toxic irritation of the mucous membrane of the lacrimal sac and lacrimal ducts. There are acute and chronic forms.
The structure of the lacrimal organs
The named organs belong to the adnexa. They include the lacrimal glands and the lacrimal ducts. The portion of the gland that is located in the orbit appears in the embryo at the age of eight weeks. However, even after thirty-two weeks of development, after birth, the lacrimal fluid in the newborn is still not secreted, since the gland remains underdeveloped. And only after two months, babies begin to cry. Interestingly, the tear ducts formed even earlier, at the sixth week of the gestational period.
The lacrimal gland consists of two parts: the orbital and secular. The orbital part is located in the notch of the frontal bone on the upper lateral wall of the orbit. The second part of the gland is much smaller than the first. It is located below, under the arch of the conjunctiva. Parts are connected by lead tubules. According to the histological structure, the lacrimal gland resembles the parotid gland. Blood supply comes from the ophthalmic artery, and innervation comes from two of the three branches of the trigeminal nerve, the facial nerve and the sympathetic fibers from the cervical plexus. Electronic impulses enter the medulla oblongata, where the center of lacrimation is located.
There is also a separate anatomical apparatus for tear abduction. It begins with a tear stream located between the lower eyelid and the eyeball. This "stream" flows into the lacrimal lake, with the upper and lower lacrimal openings adjoining to it. Nearby, in the thickness of the frontal bone, there is a bag of the same name, communicating with the nasolacrimal canal.
Functions of the lacrimal apparatus
The fluid secreted by the eye is needed to moisturize the conjunctiva and cornea. The refractive power of the cornea, its transparency, smoothness and luster to some extent depend on the layer of tear fluid that covers its front surface.
In addition, on the left performs a nutritional function, since the cornea has no vessels. Due to the fact that moisture is constantly being updated, the eye is protected by foreign objects, dust and particles of dirt.
One of the important features of tears is the expression of emotions. A man cries not only from grief or pain, but also from joy.
Tear composition
The chemical composition of the tear is similar to blood plasma, but has a large concentration of potassium and chlorine, and organic acids in it are much less. An interesting fact is that, depending on the state of the body, the composition of the tear can also change, so it can be used to diagnose diseases, along with a blood test.
In addition to inorganic compounds, the tear contains carbohydrates and proteins. They are covered with a fatty membrane, which prevents them from lingering on the epidermis. Even in the tear fluid, enzymes are present, such as lysozyme, which has an antibacterial effect. And, oddly enough, crying brings relief not only because of moral catharsis, but also because tears contain psychotropic substances that suppress anxiety.
During the time that a person spends without sleep, about a milliliter of tears is released, and when crying, this amount increases to thirty milliliters.
Lacrimation mechanism
Lacrimal fluid is produced in the gland of the same name. Then, along the output tubules, it moves into the conjunctival sac, where it accumulates for some time. Blinking transfers a tear to the cornea, moistening it.
The outflow of fluid is carried out through the lacrimal stream (narrow space between the cornea and lower eyelid), which flows into the lacrimal pond (inner corner of the eye). From there, through the channel, the secret enters the lacrimal sac and is evacuated through the upper nasal passage.
The basis of normal tearing are several factors:
- suction function of the lacrimal openings;
- the work of the circular muscles of the eye, as well as Horner's muscles, which create negative pressure in the ducts that divert a tear;
- the presence of folds on the mucosa, which act as valves.
Lacrimal examination
The age-old part of the gland can be felt during the examination, or the upper eyelid can be turned out and examined visually.
An examination of the function of the gland and lacrimal opening apparatus begins with a tubular test. With its help, the suction function of the lacrimal openings, a bag and tubules is checked. And also carry out a nasal test in order to find out the patency of the nasolacrimal canal. As a rule, one study goes into another.
If the lacrimal apparatus is in order, then one drop of a three percent collargol instilled into the conjunctiva is absorbed for five minutes and exits through the nasolacrimal canal. This confirms the staining of a cotton swab located in the lower nasal passage. In this case, the sample is considered positive.
Passive patency is checked by sensing the lacrimal tubules. For this, the Bowman's probe is carried out through the nasolacrimal canal, and then, injecting fluid into the upper and lower lacrimal openings, observe its outflow.
Causes of inflammation
In ophthalmology, quite a part there is inflammation of the lacrimal gland. The causes of the pathology can be very different - both common diseases, such as mononucleosis, mumps, flu, tonsillitis and other infections, and local pollution or suppuration near the tear duct. The route of infection is usually hematogenous.
Inflammation of the lacrimal gland can have both acute and chronic course, when light intervals alternate with relapses. The permanent form can occur due to cancer, with tuberculosis or syphilis.
Symptoms
Why not start inflammation of the lacrimal gland? Photos of patients with this pathology show that ignoring these symptoms is not so simple. And only a person who is indifferent to his health can allow the development of complications.
At the very beginning, inflammation of the lacrimal gland is manifested by pain in the inner corner of the eye. Local swelling and redness are clearly visible. The doctor may ask the patient to look at his nose and, lifting the upper eyelid, see a small segment of the gland. In addition to local, there are general signs that characterize the inflammation of the lacrimal gland. Symptoms are similar to other infectious diseases: fever, headache, nausea, fatigue, enlarged lymph nodes of the head and neck.
Patients may complain of double vision, blurred images, or problems opening the upper eyelid. With a strong reaction, the entire half of the face swells, with an affected eye. If you leave the symptoms unattended, then, in the end, the situation may worsen in phlegmon or abscess.
Inflammation of the lacrimal gland in a child proceeds in the same way as in an adult. The only difference is that the probability of spreading the infection is higher than in adults. Therefore, treatment of children is carried out in a hospital.
Local treatment
On average, the whole process from the onset of inflammation to its resolution takes about two weeks, but if you see a doctor in time, you can significantly reduce this time. An experienced specialist will quickly detect inflammation of the lacrimal gland. Treatment is usually prescribed comprehensive. After all, as already indicated in the causes of the disease, most often it is only a consequence of another infection.
Therapy begins with antibiotics in the form of drops or ointments, for example, Ciprofloxacin, Moxifloxacin, or tetracycline solution. You can attach glucocorticoids, also in the form of drops. They relieve inflammation of the lacrimal gland. After the acute period has passed, the patient is sent to the physiotherapy room for ultraviolet heating.
If an abscess has formed at the site of inflammation, then it is opened and drained through the nasolacrimal canal.
General treatment
Sometimes local measures are not enough to cure the disease, in addition, it is necessary to prevent the spread of infection throughout the body. For this, cephalosporin or fluoroquinolone antibiotics are used, which are administered parenterally. General symptoms of inflammation respond well to systemic glucocorticoids.
Usually these measures are enough to cure inflammation of the lacrimal gland. Symptoms, treatment and prevention of this disease do not constitute significant difficulties for an ophthalmologist. The main thing is that the patient in time seek help.