Blepharitis is inflammation of the eyelids. It usually involves the eyelid margins where the eyelashes grow and affects both eyelids. It's a common cause of sore, red eyelids and crusty eyelashes.
The openings (orifices) of oil glands located near the eyelashes become occluded. The pursuing changes lead to irritated and red eyes. Blepharitis is usually associated with an overgrowth of bacteria along the eyelid margins forming a structure called “biofilm”. And, parasitic eyelash mites called “Demodex” feed on this film. Consequently, the overgrowth of these mites on “biofilm” causes a worsening of the eyelid inflammation.
Congenital nasolacrimal duct obstruction occurs when the lacrimal duct has failed to open at birth, most often due to an imperforate membrane (Hasner Valve) at the inferior end of nasolacrimal duct.
These babies present a persistent watery eye even when not crying. A sticky and mucupurulant discharge may be present if a secondary infection occurs.
Most cases resolve in few months after birth, by opening of the obstructing membrane spontaneously.
The obstruction of the lacrimal drainage system present with tearing (epiphora, watering of eye), a complaint frustrating to patients needing always a wiper on hand.
Nasolacrymal duct (NLD) obstruction is the most common clinical entity of lacrymal drainage system causing outflow of tears, epiphora (watery eye). Chronic dacryocystitis is an infection or inflammation of the nasolacrimal sac, usually caused by blockage of the nasolacrimal duct (NLD).
Diagnosing dacryocystitis is relatively easy with a history of chronic epiphora and sticky discharge dating back several months or years. The definitive diagnosis is usually done by saline injection (lavage) through the canaliculi. The saline will not pass into the nose and come back (together with mucopurulent secretion collected in sac) through the canaliculi.
The definitive treatment of dacryocystitis is surgical. A wide variety of stents (mono or bicanalicular silicone stents, Jones tube ..) and microsurgical techniques may be used during these procedures according to the type and level of the obstruction.