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Dry eye
Dry eye is a chronic condition caused by decreased production of tears or an increased rate of evaporation of the tear film, which covers the cornea. This situation affects the lives of millions around the world and is one of the most common causes for visiting the ophthalmologist.
The eyes are usually red, dry, and the patient complains of itching, burning and foreign body sensation.
In many cases, dry eye causes reflex tearing and patients visit the ophthalmologist because of "runny" eyes.
Predisposing factors include advancing age (very often post-menopausal women), the environment (air pollution, use of air conditioners, etc.) and the modern way of life (reading, television, computer use, etc.).
Dry eye is also the result of some systemic diseases such as rheumatoid arthritis and systemic lupus erythematosus, and drug taking such as antidepressants, allergy and hypertension medication, etc.
If dry eye becomes severe and is left untreated, it can lead to infections or other complications that may also affect the vision.
Treatment can be conservative, using artificial tears, or a solution may be sought in other methods. It is important for the patient to recognize the symptoms early on and report them to the ophthalmologist as soon as possible.
Dacryocystitis
The inflammation of the lacrimal sac is called dacryocystitis and it is usually due to the obstruction of the nasolacrimal duct. The pooling of tears favors conjunctival bacterial growth, leading to infection and the formation of pus.
Nasolacrimal duct obstruction can occur at any age.
In acute cases the patient has pain, swelling and redness in the area, tearing, and fever, if the situation becomes serious. In chronic cases the main symptom is tearing.
Treatment of acute dacryocystitis includes oral antibiotics and warm compresses. In chronic cases, especially if recurrent, an attempt will be made to surgically open the communication between the lacrimal sac and nasal cavity by bypassing the nasolacrimal duct. This procedure is called dakryocystorhinostomy.
Dakryocystorhinostomy can be performed either externally (traditional method) or endoscopically. In the case of endoscopic cystorhinoscopy, the lacrimal sac is accessed through the nose with a special endoscope. The advantages of this method is the absence of external incisions, extremely high success rates and fewer complications.
In cases where the lacrimal tract is obstructed by adhesions, without evidence of inflammation, dakryocystorhinostomy tends to be replaced by the intubation of lacrimal tract. In do so, we remove the adhesions with a special catheter and insert a silicon tube, which remains in situ for several months in order to prevent the development of new adhesions.