Российский офтальмологический журнал (Oct 2018)
Fungal canaliculitis: diagnostics, treatment, prevention
Abstract
Up to 2.4 % of primary patients seeking ophthalmological care are cases of canaliculitis. Purpose: to systematize the methods of diagnosing, treatment and relapse prevention of fungal canaliculitis on the basis of the authors’ experience. Material and methods. The results of diagnosing, treatment and relapse prevention are systematized based on the analysis of examination of 57 patients aged 46 to 89 with tear duct disorders of micotic origin. Results. Canaliculitises of fungal etiology are characterized by chronic course of the disease and complications caused by late diagnosis and prolonged inadequate treatment. Practical ophthalmologists should be aware of the fact that this pathology develops primarily in senior females suffering from chronic conjunctivitis and inflammatory disorders of ocular adnexa within the tear duct area that are resistant to antibiotics. A plan of diagnostic examination is recommended based on the analysis of the clinical picture, determination of patency of lacrimal passages during washing and probing, and canalicular and nasolacrimal assays. We also used bacteriological methods of study and X-ray contrasting of tear ducts. The main technique of treatment of fungal canaliculitis is surgical dissection of lacrimal canaliculi, removal of their content with subsequent instillations and washing of tear ducts with antiseptics and antifugal preparations. In the follow-up period spanning 2 months to 5 years no relapses of the process were observed. Conclusion. The use of special diagnostic methods based on the analysis of clinical picture and surgical treatment combined with antimicotic preparations is necessary for relapse prevention and rehabilitation of patients with fungal diseases of lacrimal canaliculi // Russian Ophthalmological Journal, 2016; 4: 74-9. doi: 10.21516/2072-0076-2016-9-4-74-79.
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