All disease of lacrimale system

2. DISEASE OF LACRIMAL
SYSTEM
Dr. Abdul Basir safi
Lecturer of Nangrahar
Medical faculty
eye department
E-mail:
basirsafi123@yahoo.com

3. ANATOMY OF
LACRIMAL SYSTEM
• Applied anatomy
1. Secretory system
• LACRIMALGLANDS
• Palpebral part
• Orbital part
1. Accessory lacrimal glands
• glands of Krause
• glands of wolfering
• Goblet cells

5. ANATOMY OF
LACRIMAL SYSTEM
2. Excretory system
• Lacrimal puncta (0.5mm)
• Ampola (2mm)
• Lacrimal canaliculi (7-8mm)
• Common canaliculi(rare)
• Lacrimal sac
• Nasolacrimal duct.(12mm)
• Hasner valve

8. TEARS ‫اوښکی‬
• Contentment of tears
• Average secretion of tears
• Tear film
• Three layer
• Mucous layer
• Aqueous layer
• Lipid layer
•TEAR FUNCTION

9. CHRONIC
DACRYOCYSTITIS
•Etiology
‫سترګه‬ ‫اوبړنه‬WATERY EYE

10. ‫سترګه‬ ‫اوبړنه‬WATERY EYE
• Lacrimation
Due to stimulation of trigeminal
nerve excessive secretion or tear
otherwise lacrimal duct is open
• Epiphora
Due lacrimal drainage system
obstruction water is outing from
lid margin

11. DISEAS OF THE LACRIMAL
GLANDES
ACTE DACRYO ADENITIS
• Etiology
• Sign and symptom
• Complication
• Treatment

12. DACRYOCYSTITIS
Classification of Dacryocystits
Congenital
Dacryocystits
Acquired
Dacryocystits
Chronic
Dacryocystits
Acute
Dacryocystits
CONGENITAL DACRYOCYSTITIS
Complication
Treatment
1. Medical treatment (MASSAGE OVER
LACRIMAL SAC)
2. SURGICAL TREATMENT

13. Treatment of congenital nasolacrimal
duct obstruction
• Massage of nasolacrimal duct and antibiotic drops 4 times daily
• Improvement by age 12 months in 95% of cases
• If no improvement - probe at 12-18 months
• Results - 90% cure by first probing and 6%
•by second

16. ACUTE
DACRYOCYSTITIS
• Etiology
• Symptoms
1. Sign of inflammation
2. No regurgitation
3. Conjunctival congestion
4. Sub maxillary lymph nods enlarge
5. Fluctuation
6. Lacrimal fistula

17. ACUTE DACRYOCYSTITIS
• Complication
1. Osteomyelitis
2. Orbital cellulitis
3. Cavernous sinus thrombosis
TREATMENT
• Hot compresses
• Systemic antibiotic
• Analgesic and anti inflammatory
• If abscess = abscess drainage
• Lacrimal fistula= excision fistula and
remove of sac
• DCR after acute infection is controlled

19. CHRONIC
DACRYOCYSTITIS
• Chronic suporrative inflammation of
sac
• Due to nasolacrimal duct obstruction
• Source of infection in sac.
• Types :
1. Catarrhal
2. Mucocele
3. Supperative
Pathogenesis

20. Catarrhal

21. Mucocele
Suporrativ
Regurgetation test

22. CHRONIC DACRYOCYSTITIS
• Signs and symptoms
1. Epiphoria
2. Swelling over sac
3. In cause of infection five s.s of inflammation
4. Persistent congestion
5. Regurgitation and mucopurulent fluid
• Complication
1. Corneal ulcer
2. Panophthalmitis
3. Atonic sac
4. Lacrimal abscess
5. Lacrimal fistula
6. osteomilitis

23. CHRONIC DACRYOCYSTITIS
• Investigations
1. Nasal examination
2. Radiological examination
A- Dacryocystography (DCG)
B- Radioactive tracer
• Treatment
I. Repeating of syringing
 Method …
• Diagnostic
• Therapeutic
• Initially daily then weekly
II. Surgical treatment

24. CHRONIC DACRYOCYSTITIS
• Surgical treatment
1. Dacryocystectomy:
surgical removal of
lacrimal sac
Method:

25. CHRONIC
DACRYOCYSTITIS
•Dacrocystorhinostomy : way
from sac to nasal mucosa

26. CHRONIC DACRYOCYSTITIS
• tube implantation (lester jones tube)
1. When no puncta or canaleculi:
direct tube from Conjunctival sac
2. When failed DCR or suitable for
silicon intubation

27. •‫سوالونه‬
•‫کړی‬ ‫تشریح‬ ‫جوړښتونه‬ ‫اناتومی‬ ‫سیستم‬ ‫اوښکود‬ ‫د‬.
•Lacrimal dacroadinitis‫اختالطات‬ ‫او‬ ‫دملنه‬ ‫کړی‬ ‫تشریح‬
‫کړی‬ ‫واضح‬.
•‫شو؟‬ ‫کولی‬ ‫توپیر‬ ‫څنګه‬ ‫یی‬ ‫سره‬ ‫ډکریوپ‬
•‫کړی‬ ‫تشریح‬ ‫پړاونه‬ ‫درملنی‬ ‫او‬ ‫علتونه‬ ‫ډکوسیستیت‬ ‫والدی‬‫؟‬
•‫ووای؟‬ ‫یی‬ ‫موثریت‬ ‫او‬ ‫طریقه‬ ‫پروبینګ‬
•‫ا‬ ‫اختالطات‬ ‫او‬ ‫درملنه‬ ‫عالیم‬ ‫اعراض‬ ‫ډکروسیستیت‬ ‫والدی‬ ‫حاد‬ ‫د‬‫و‬
‫زکرکړی؟‬ ‫نومونه‬ ‫بابړی‬
•‫او‬ ‫دی‬ ‫ډوله‬ ‫عالیمڅو‬ ‫او‬ ‫اعراض‬ ‫ډکروسیستیت‬ ‫والدی‬ ‫مزمن‬
regurgitation test‫وی؟‬ ‫مثبت‬ ‫کله‬
•‫کړی؟‬ ‫تشریح‬ ‫پړاونه‬ ‫درملنی‬ ‫د‬ ‫ډکروسیستیت‬ ‫مزمن‬ ‫د‬

28. ‫پوښتنی‬‫؟‬