In infants and young children, episodes of conjunctivitismay occur repeatedly. Most often this is linked to the persistence of a small membrane that closes the tear duct (duct through which excess tears flow into the nasal passages).
Clinically, non-permeability of the nasolacrimal duct results in dirty, unilateral or bilateral tearing, beginning 8 to 15 days after birth, with more or less purulent secretions. Indeed, the inability to flow will cause tears to stagnate on the conjunctiva. This abnormal stagnation will promote superinfection of the eye membranes by germs. Most of the time, it is enough to clean and wait for the small membrane to perforate. This can take several weeks and conjunctivitis can be recurrent and will need to be treated with antiseptic eye drops or antibiotics.
If the problem persists, we will have to re-permeabilize the tear duct: to do this, we perforate the membrane with a very fine thread that is passed into the opening of the tear duct. This is a simple procedure performed by the ophthalmologist.
It should not be done too early (before 3 months) because things often get better spontaneously, nor too late (after 6 months) because then it is difficult to probe this tiny orifice in a baby who is struggling.
To summarize, the treatment regimen is as follows:
- Between 0 and 2 months: clean the eye with saline solution upon waking and reserve antibiotics for real infectious episodes.
- If this tearing persists after 6/8 weeks, you should consult an ophthalmologist.
- Between 2 and 3 months: attempt to rupture the membrane by a series of massages carried out by pressing on the canaliculi with a finger placed at the level of the internal canthus and exerting good pressure on the lacrimal sac.
- Between 3 and 6 months: canal probing without anesthesia, performed by an ophthalmologist.
- After 12 months: catheterization under general anesthesia to place a probe in the canal, removed after 6 weeks.
