The lacrimal gland produces tears which enter into the "duct" that drain the tears from the eye into the nose. The most common symptoms are
(1) excess tearing (tears may run down the face) and
(2) mucous discharge
If one has a plugged up "tear duct," not only will tears spill over the eyelids and run down the face, but the stagnant tears within the system can become infected.
This may lead to recurrent red eyes and infections.
The excessive tearing can also produce secondary skin changes on the lower eyelids.
Congenital Nasolacrimal Duct Obstruction
Nasolacrimal Duct Obstruction (NLDO) is very common in infants.
Children are frequently born with an obstruction within the "tear duct." In fact, 6% of all children are born before their tear ducts are open.
The stagnant tears within the "tear duct" often become infected causing pus (heavy matter) to collect between the eyelids.
Antibiotics may help some of the symptoms, BUT this is not cure for the blockage
Such obstructions may resolve spontaneously within the first few months of life. In fact, 95% of these children will show resolution before their first birthday. If it does not resolve surgery may be necessary.
Blockage presents in one of four ways:
simple obstruction
congenital fistula (as seen to the left)
acute dacryocystitis
congenital dacryocele or mucocele
Location of Blockage
The very end of this duct is the most common place for blockage to occur. This site is called the valve of Hasner at the distal nasolacrimal duct and may represent failure of canalization of the epithelial cells that form the duct.
Medical Treatment of Congenital Obstructions
Many of these do open on their own given time.
Massaging from the tear sac in the may help create a pressure wave that can open the blockage.
Graves' disease is an autoimmune disease. It most commonly affects the thyroid, causing it to grow to twice its size or more (goiter), be overactive, with related hyperthyroid symptoms such as increased heartbeat, muscle weakness, disturbed sleep, and irritability. It can also affect the eyes, causing bulging eyes (exophthalmos). It affects other systems of the body, including the skin and reproductive organs. It affects up to 2% of the female population, often appears after childbirth, and has a female:male incidence of 5:1 to 10:1. It has a strong hereditary component; when one identical twin has Graves' disease, the other twin will have it 25% of the time. Smoking and exposure to second-hand smoke is associated with the eye manifestations but not the thyroid manifestations. Diagnosis is usually made on the basis of symptoms, although thyroid hormone tests may be useful, particularly to monitor treatment.
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