SWOLLEN PUNCTA

SWOLLEN PUNCTA

 

If you have a swollen puncta, tears will not flow normally, making the eyes watery and inflamed. This problem may be caused by a partial or a complete obstruction of the drainage system that handles your tears.

In children, this condition (swollen puncta) might be commonly seen. The condition usually improves within the first year of life without treatment. In adults, obstruction of the lacrimal duct can be caused by an injury, infection, or, rarely, a tumor.

Obstructed lacrimal ducts can be corrected in most cases. Treatment depends on the cause of the obstruction and the age of the affected person.

In this article, we will discuss about:

 

HOW DOES THE DRAINAGE SYSTEM WORK?

SYMPTOMS OF BLOCKED PUNCTA.

CAUSES OF SWOLLEN PUNCTA:

RISK FACTORS.

WHEN TO SEE A DOCTOR?

DIAGNOSIS.

TREATMENT.

PREVENTION.

TAKEAWAY.

 

 

HOW DOES THE DRAINAGE SYSTEM WORK?

The lacrimal glands produce maximum of your tears. These glands are located within the upper lids above each eye. Normally, tears go with the drift from the lacrimal glands over the floor of your eye. Tears drain into openings (puncta) at the inner corners of your upper and lower eyelids.

The puncta cause small canals (canaliculi) that circulate tears to a sac to a reservoir at the facet of the nose (lacrimal sac). From there tears journey down a duct (the nasolacrimal duct) and drain into your nose. Once withinside the nose, tears are reabsorbed.

A blockage can arise at any factor withinside the tear drainage system, from the puncta in your nose. When that happens, your tears don`t drain properly, providing you with watery eyes and growing your danger of eye infections and inflammation.

 

SYMPTOMS OF BLOCKED PUNCTA:

Most commonly, a blocked puncta causes a person to experience watery eyes and tears that come down from your eyes.

Other symptoms of blocked puncta may include:

  • Swollen puncta.
  • Discharge coming out of eye, or mucus coming out of it.
  • Formation of crust on your eyelids.
  • Infections, like conjunctivitis (which is also known as pink eye).
  • Vision that is blurred.
  • Pain on the inside of the eye (the corner of it).

Epiphora (or the watering of eyes) can occur with colds, sinus infections, or eye infections that are not related to the lacrimal duct. Wind and bright sunlight can also cause excessive tears.

Swelling around the eyes and redness of the eyes can also be the result of eye damage and may or may not affect the lacrimal duct.

If obstruction of the lacrimal duct is the result of a bacterial infection, fever may occur along with these other symptoms.

 

Causes of swollen puncta:

  • INFECTION

Dacryocystitis refers to an infection of the lacrimal sac that is part of the tear drainage system of the eye. Tears flow out of each eye through small tubes (drainage tubes), lacrimal sac, and lacrimal ducts.

The drainage channel is located in the inner corner of the upper and lower eyelids and drains the tears that washed the front of the eye. These tubes lead to the sac of tear, also known as the lacrimal sac, and travel through the lacrimal sac to the lacrimal duct (tear duct) and then to the nose.

The usual causes of Dacryocystitis are obstruction of the lacrimal duct and retention of tears in the lacrimal sac. The lacrimal sac can become inflamed and swollen, causing Dacryocystitis. This condition often causes watery eyes, redness of eyes, and swollen puncta.

Dacryocystitis can be acute, chronic, congenital, or acquired. Symptoms of Dacryocystitis are often mild, but in severe cases, fever may occur. An abscess (a collection of pus) can form and break the skin.

Wherein, the symptoms of acute and the chronic Dacryocystitis are different.

Symptoms of acute Dacryocystitis include:

  • Pain.
  • Redness of eyes, which can spread to your nose bridge.
  • Swollen puncta.
  • Discharge via eyes, which is usually purulent.
  • Tearing or watering of eyes.

Symptoms of chronic Dacryocystitis include:

  • Tearing or watering of eyes.
  • Visual acuity changes (because of production of a tear film).

 

  • CONGENITAL BLOCKAGE.

In some babies, the opening to the lacrimal duct is not properly formed. This leads to blockage and the inability to shed tears. This condition is called congenital lacrimal duct obstruction, or dacryostenosis. Obstruction of the lacrimal duct can involve one eye at a time, or both the eyes.

Infants do not shed tears until a few weeks of age, so there may be no obstruction of the lacrimal duct at birth. It may also be noticeable only when the baby is crying or in cold or windy weather where tears are irritating.

Fortunately, almost all obstructed lacrimal ducts usually open spontaneously by the age of one.

Symptoms of congenital blockage of lacrimal duct include:

  • Swollen puncta.
  • Pooling of tears in the corner of eyes.
  • Discharge from eyes which is yellow and mucus.
  • Redness around eyes and nose.

 

  • INJURY.

A harm to the lacrimal drainage system can cause scarring and stenosis, which can cause epiphora (a situation wherein tears run over the margin of eyelid and onto the cheek). Canalicular trauma can be due to direct or oblique injury to the canaliculus. Direct harm can be due to penetrating trauma with any item consisting of glass, metal, or natural material.

A bite because of canine harm may additionally bring about direct harm to the canaliculus and, in fact, are much more likely to bring about canalicular harm than in eyelid lacerations from different causes.

Indirect harm is much more likely to arise with a fist punch to the face, finger poke, or diffuse harm from an effect consisting of can also additionally arise in a motor car twist of fate or a fall. Injury to lacrimal duct may also cause swollen puncta.

 

  • TUMOR.

If you have a tumor in nose or anywhere in the drainage system of tears, it may cause your lacrimal duct to be blocked causing swollen puncta.

 

  • CANCER TREATMENT.

Blocked lacrimal duct may also be caused by medication used for chemotherapy or radiotherapy. This may cause your puncta to be swollen.

 

RISK FACTORS.

Because swollen puncta is almost always caused by a blocked lacrimal duct, there are some factors that put you on risk of getting your duct blocked. These risk factors are as follows:

  • Age: because age related changes can cause lacrimal duct to be blocked, old aged people are at a risk.
  • Chronic inflammation of eye: if you have conjunctivitis, you may be at a high risk of getting your lacrimal duct blocked.
  • History of surgeries.
  • Glaucoma.
  • Cancer treatment.

 

WHEN TO SEE A DOCTOR?

If you have a swollen puncta and see any of the below mentioned symptoms, see a doctor (or an ophthalmologist):

  • Excessive watering of eyes, such that it begins to interfere with your life.
  • Eye infection that occurs and come back frequently.
  • Irritated eyes.
  • Blood in tears.
  • Fever.
  • Redness or swelling in your eyes and around your nose.
  • Vision changes (blurry, double vision, or sensitivity to light).

 

DIAGNOSIS.

Ophthalmologists can use physical examinations and diagnostic tests to diagnose swollen puncta. You will always be asked to provide the doctor with a complete medical history. Your doctor will look in and around your eyes. You may also run or order specific tests such as:

Lacrimal gland test: This test measures the rate at which tears are shed. A special dye drop is applied to the surface of each eye. If the drops remain on the surface of the eye after 5 minutes, the lacrimal duct may be swollen or clogged.

Imaging Eye Test: Contrast passes through the tear drainage system from the corner of the eyelid. Then either a magnetic resonance imaging (MRI) or computed tomography (CT) scan of the area is performed.

Flushing and Probing: done to check how well the saline is flushed through the tear drainage system. They insert the probe into a small drain hole (called a punctum) in the corner of the lid to check for clogging.

 

TREATMENT.

Treating swollen lacrimal ducts can relieve symptoms such as tears, pain, and redness. Treatment can open or bypass the obstructed lacrimal duct and allow tears to drain normally. There are things you can do at home to unblock channels. However, surgery may be required in some cases.

 

PREVENTION.

To prevent the risk of getting your lacrimal duct blocked, get your infections and all the kinds of inflammations treated as soon as possible. What you may try other than this is:

  • Wash the hands frequently, and thoroughly so.
  • Try not rubbing your eyes.
  • Don’t share your cosmetics with anyone.
  • Keep your contact lens clean, in case you use them.

 

TAKEAWAY.

The lacrimal duct works by draining tears from your eyes to the nose. Swollen puncta can be due to an infection or obstruction.

Symptoms of swollen puncta include excessive tears, eye secretions, chronic nasal infections, or injuries. Self-care measures such as warm compresses are effective in clearing the obstruction of the ducts. If they do not work, antibiotics or mild surgery may be needed.

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