What to do if a newborn child is festering and watering his eyes: what to wash, drops

The eyes of the newborn are festering - this is a very serious symptom, which can be either with an infectious disease of the respiratory tract or other organs, or with functional disturbances in the organ of vision. The defeat of a child's eyes should always be alarming, since it affects not only sight, but also the development of the child in the future, because he knows the world around him with the help of vision, hearing and smell.

Statistics of the spread of suppuration of the eye indicate that more than 12% of all children face this problem even in the period of newborn. Among the reasons in the first place is dacryocystitis, and on the second - adenovirus infection. This suggests that the etiological treatment in this case is very important.

[1], [2], [3], [4]

Causes of purulent formations on the child's eye

Naturally, if a child has a festering glaze, then an inflammatory process takes place involving the bacterial, fungal or viral flora. But the cause is not always directly infectious agent. Therefore, all causes can be divided into two groups: infectious and non-infectious.

Among the bacterial pathogens, any agent can cause inflammation. In this case we are talking about purulent conjunctivitis. The reason for this process is that the bacteria enters the child's eye and actively multiplies. At the same time, protective mechanisms can not ensure the evacuation of a bacterial agent and an inflammatory process occurs. So the eye begins to fester. The causative agent is more often stafilokkok, streptococcus, sticks. They enter the eye in an exogenous way and cause an inflammatory response there. But not all children develop such infection. Risk factors for the development of such inflammation are the prolonged stay of the child in a hospital institution where there is a constant circulation of microorganisms. In addition, the development of bacterial conjunctivitis is prone to babies born with rupture of the fetal sac and meconial waters. The content of meconium in the amniotic fluid irritates the mucous membranes of the eye and may cause a predisposition to further inflammation.

If the eyes of a newborn are festering, then one of the reasons for this may be a mother's gonorrhea. This disease is characterized by the defeat of the genital organs of the mother, and when the baby is born, then the pathogen to the mucous eye, is necessarily there delayed. Soon this leads to the development of inflammation. But this is a very rare reason for today, since all mothers before birth are thoroughly examined.

Among viral agents, the cause of the festering eye in a newborn is an adenovirus. Adenovirus infection is a widespread respiratory disease in children, which in most cases affects the conjunctiva, sclera, and lymphatic system. Adenoviruses are reproduced in the epithelium of the respiratory tract, where it is possible to detect characteristic intranuclear basophilic DNA-containing inclusions and adenoviral antigen clusters. The virus is tropic to all mucous membranes, therefore the inflammation is manifested by a strong exudative component. The cause of infection of newborns may be a sick person who is in contact with the child, or simply a carrier of the virus. Through droplets of saliva and air, the virus enters the tropic cells. These cells are the epithelium of the nasopharynx or directly conjunctiva. There, the virus multiplies and can, through the lymphatic system, cause inflammation of both the regional lymph nodes and the lymphatic plexuses of the intestine. This causes a consistent development of all symptoms.

Why the eyes of the newborn are festering, if for this there are no causes of an infectious nature and the child is completely healthy. A common cause of this is in newborn babies is dacryocystitis. The pathogenesis of dacryocystitis is inflammation of the conjunctiva due to the obstruction of the nasolacrimal canal.

The eye is protected from the action of microorganisms, pebbles by the release of tears. A tear follows from the lacrimal sac at the outer edge of the eyelid and, while washing the eyelid, drains into the nasolacrimal canal. So the tear is "in the nose" and all the excess particles from the eye are removed. In children, when they are in utero, the nasolacrimal canal is closed with a stopper that has a gelatinous structure. After birth, this plug must be removed by itself. But this does not always happen, and this cork in newborns can remain on one side or on both sides. Then, when there is a violation of the outflow of tears, stagnation occurs and conditions for the multiplication of microorganisms are created. This leads to the fact that the eye begins to fester. Thus, inflammation is also there, but the bacterial agent in this case is a secondary factor.

[5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]

Clinic of diseases, which are accompanied by suppuration of the eye in a newborn

Symptoms of adenovirus infection in a child can begin in a few hours or days after contact with a sick person and after infection. The first signs of the disease begin at the site of infection. Then the child has an acute increase in body temperature and there are catarrhal symptoms. The nose of the child is laid, and later there is a sharp rhinitis. Exudative processes are also observed on the posterior wall of the pharynx with marked granularity and friability of the throat. Lymph nodes increase, reacting to the inflammatory process. Therefore, in addition to the discharge from the nose, the child may have a cough due to inflammation of the posterior pharyngeal wall. A few hours later, or on the second day after the first symptoms of the disease, eye damage appears in the form of conjunctivitis. At the same time, the eye of the newborn is tearing and festering, precisely because of the virus damage to the conjunctival membrane, which can also cause redness. The process, as a rule, is two-sided, with the subsequent defeat first of one eye, and then the other. In addition to the expressed local catarrhal phenomena, there are also systemic manifestations. The child does not breathe well with his nose, so he does not sleep well and can not eat normally. The temperature rise can be up to the low-grade figures and is held no more than three days.

One of the infrequent symptoms of adenovirus infection is intestinal damage. This can be manifested by a slight disorder of the stool, which lasts no more than one day and does not bring discomfort to the baby.

If the eye is strongly swollen and festering in the newborn on one side, then it is more often the manifestation of dacryocystitis. Cork nasolacrimal canal, as a rule, is preserved from one side, so the manifestations of dacryocystitis are often one-sided. Symptoms appear gradually and increase with each passing day. Mom notices that the child, especially in the morning, suppurates the eye. The intensity of this throughout the day decreases, but every day it repeats again. The eye can look swollen, red, often watery.

If the left and then the right eye of the newborn dies in dacryocystitis, then it is possible that a long untreated process leads to the infection of one eye first, and then the other. In this case, we are talking about a high probability of bacterial inflammation.

[16], [17], [18], [19], [20], [21]

Consequences and complications

The consequences of dacryocystitis are assessed after the first two weeks of the child's life. In most newborns, the plug of the nasolacrimal canal can resolve until the end of the second week of life, so no action should be expected during this period.

If we are talking about the fact that the eyes of the newborn are festering, as a result of adenovirus infection, then in this case there can be infectious complications. When the infection spreads to neighboring organs, otitis, sinusitis, and sinusitis can develop. Less frequent but more serious complications are pneumonia, pleurisy. Timely diagnosis of the cause of suppuration of the eye in a child can prevent the development of any complications.

[22], [23], [24], [25], [26], [27]

Diagnostics

Diagnosis of pathologies is carried out immediately at the stage of examination of the baby. If, in addition to suppuration of the eye, there are other symptoms - rhinitis, fever, it is likely that it is a virus infection of the upper respiratory tract. In this case, you need to carefully examine the baby. First you need to perform auscultation of the lungs. At the onset of the disease, when there are no complications, breathing should be vesicular. Next, you need to go to the examination of the posterior pharyngeal wall. With a careful examination with a spatula, one can see flushing of the posterior wall or arches, it is possible that the granularity of the posterior wall in newborns can be expressed slightly. The presence of these symptoms and manifestations of conjunctivitis indicates an adenovirus infection. For a specific diagnosis of the virus, it is possible to perform additional laboratory tests. The material for analysis can be scraping from the conjunctiva or from the posterior pharyngeal wall. Next, a polymerase chain reaction is performed to identify the antigen of the virus in the material. Determination of the DNA-containing virus says exactly about the adenovirus infection. But such a survey is very rare, because the time spent on the tests does not allow a specific treatment to be started on time. Therefore, if there is a combination of clinical manifestations, a diagnosis can be made. If necessary, laboratory diagnostics are carried out in the following main directions. First, identify specific viral particles in the cells of the epithelial layer of the respiratory tract or conjunctiva with the introduction of specific methods - immunofluorescence and enzyme immunoassay; stool analysis allows you to rarely identify a virus only if there are severe intestinal disturbances. Secondly, the identification of viral particles is carried out with the introduction of a culture of cells on which their cultivation is carried out with further investigation.

Third, a diagnostic study of blood serum. To do this, examine the blood at the beginning of the disease at the level of antibodies against the given virus, and then after two weeks the level of antibodies should increase fourfold. This allows you to retrograde the diagnosis.

Diagnosis of dacryocystitis should be performed only by a doctor-ophthalmologist. The pediatrician should establish a preliminary diagnosis and send for consultation to the oculist. When examining a child, you can establish that only one eye is festering. With palpation, it can be determined that the inner edge of the eye is densified in the area of the nasolacrimal canal. There may also be purulent discharge from the nose from the side of the affected eye. In this case, a child can snore and sniff.

Instrumental diagnosis can be limited to trial probing and washing of the nasolacrimal canal. To do this, take saline and inject the child into the nasolacrimal canal in the region of the morning of the century. With dacryocystitis, the liquid does not pour through the nose.

[28], [29]

Differential diagnostics

Differential diagnosis of suppuration of the eye in a newborn should be carried out with allergic conjunctivitis, diphtheria of the century, bacterial primary conjunctivitis. Allergic conjunctivitis is a bilateral process, which in newborns is a rare single symptom, more common in combination with skin allergic manifestations. Bacterial conjunctivitis forms dense green-yellow festering plugs on the eyes, without catarrhal manifestations, in contrast to adenovirus. It leads to an increase in body temperature only because of inflammation of the eyes, even without the presence of other manifestations.

Diphtheria is a complex bacterial disease, which in the modern world is rare due to vaccination. The newborn child still has persistent immunity from the mother, so exclude diphtheria in the last place. Films in the eyes of diphtheria form dense conglomerates, which are very difficult to leave with hemorrhages.

These are the main diagnostic criteria that allow you to establish a preliminary diagnosis for suppuration of the eyes in a newborn.

[30], [31], [32], [33], [34], [35]

Treatment

When starting treatment of patients with conjunctivitis, which is caused by adenovirus or accompanies any other viral infection, the following principles are used:

1. The child needs to provide 24-hour supervision and care. Satisfactory appearance and good general state of health at the onset of the disease do not always correspond to the severity of the disease. Violation of the regime can sharply aggravate the infectious process, worsen the course of the disease, and also contribute to the "dispersion" of viruses.
2. Complete breastfeeding in small portions contributes to successful treatment. After all, the milk of the mother contains not only nutrients, but also the factors of protection from viruses. It is necessary to remember the following circumstance: the energy expenditures in children of patients with viral infections do not change significantly, but the need for vitamins is much greater than in healthy ones. Therefore, the mother should eat well when feeding a sick child.
3. Since conjunctivitis is not dangerous in and of itself, and in connection with possible complications, it is necessary to appoint an individualized complex treatment taking into account the premorbid state of the child's organism, preferring the most effective antiviral and pathogenetic means.
4. Antibiotics and sulfonamides not only do not have antiviral activity, but also suppress the immune system, cause the development of dysbiosis and allergic reactions. Therefore, the use of these drugs is limited to specific clinical indications.
5. Fever in patients should be considered primarily as an important protective reaction of the organism that has evolved in the course of evolution. Therefore, the prescription of antipyretic drugs may cause the baby harm, sometimes irreparable. The body should necessarily control the temperature of the body, but it is necessary to reduce the figures above 38.5.

Perspective in the treatment of newborns with suppuration of the eye of the viral etiology is the use of interferons. Interest in interferons is now significantly increased.

It has been established that both natural and microbial synthesis interferon possesses a significant therapeutic potential and is able to protect cells and the human body as a whole from a number of widespread viral infections.

A feature of interferons is a wide range of their immunotropic action. They activate T-lymphocytes, including T-helpers, stimulating antibody formation, and T-helpers, which stimulate the maturation of natural killers, as well as some subpopulations of B cells. Thus, under the action of interferon in the cell, activation of nonspecific protective immune forces occurs.

If the main function of the immune system is to control the protein composition of multicellular populations, then in this system interferons have a leading role in monitoring the genetic stability of the organism. Normally, three variants of interferon activity of leukocytes are distinguished: strong (more than 128 IU / ml), medium (32-64 IU / ml) and weak (less than 16 IU / ml) interferon producers. Most healthy newborns have a strong or moderate ability to produce. In 75% of healthy children, serum interferon is not manifested. But the newborns may not yet have fully formulated the system of such immune response, so they can be ill with varying severity of gravity.

Acute viral infections in the majority are characterized by transient development of a lack of interferon.

Short-term use of interferon in the form of inhalations for 2-3 days facilitates the course of any viral infections. At the same time, injections of interferon too strongly cause a violent reaction of the body and are themselves capable of provoking an influenza-like syndrome.

Medications for suppuration of the eye should take into account the cause of this process. With adenoviral conjunctivitis, antiviral drugs are among the most important in eliminating symptoms.

1. The most affordable and cheap is the Russian interferon drug Laferon. It exhibits a sufficiently pronounced antiviral and immunomodulatory effect. Clinical observation showed that inhalation application of laferon promotes the rapid disappearance of signs of the disease, a significant decrease in endogenous intoxication and allergization of the body, normalization of immune shifts. At the same time for 2.5-3 days the duration of fever is shortened, for 3-4 days the manifestations of intoxication decrease (in the form of malaise, adynamia, loss of appetite).

Inhalation application of laferon positively affects the cellular and humoral units of immunity, helping to eliminate the imbalance in the population composition of immunocompetent cells that has arisen as a result of the disease. After the inhalation of laferon normalization of the immunoregulatory index (CD4 / CD8) occurs, the induction of g- and a-IFH-interferon is activated (by 2 and 1.6 times, respectively), and the serum immunoglobulin A content also increases.

The most optimal way to realize the virucidal effect of laferon is its inhalation administration.

The advantages of this are:

• Rapid intensive assimilation of laferon due to vascularization of the mucosa of the respiratory tract;
• Preservation of laferon in the submucosal layer;
• Direct action on the focus of infection and pathogen;
• Receipt of the drug directly to the affected cells of the target organ (this circumstance prevents the dispersion of the drug throughout the body).

Method of application - inhalation in a dose of 500 thousand IU once a day. This dose of laferon can be obtained by diluting an ampoule with 1,000,000 IU of laferon in 5 ml of distilled or boiled, chilled to room temperature water. In 2.5 ml of this solution contains 500 thousand IU of laferon. For inhalation, newborns should use inhalers with a special mask. Contraindications for endonasal and inhalation methods of Laferon administration are not established.

2. Proteflazid is a drug containing flavonoidal glycosides isolated from domestic cereals. One drop of the drug contains 2 to 5 μg of these compounds. The mechanism of pharmacological action of Proteflazide is due to the fact that plant flavonoid glycosides neutralize the action and activity of viral particles. This occurs by disrupting the synthesis of their DNA in the cells of the epithelium. This leads to the cessation of the production of new virus particles. In addition, the glycosides of the drug increase the production of endogenous interferons, increase reactivity to infectious agents, exert a stimulating effect on the immune system, thereby contributing to the elimination of immunodeficiency. The treatment with proteflasid helps normalize the T-lymphocyte count of CD3 + and the ratio of CD4 / CD8 lymphocytes. Thus, proteflazide is also effective and can be widely prescribed to sick children.
3. Antiviral agents often use Resistol. This drug has an antiviral and immunomodulatory effect, significantly improves protein metabolism, increases the level of immunoglobulins in the blood serum, and shortens the duration of the main clinical signs of viral conjunctivitis. The way of using the drug is in the form of drops. Dosage is 10 drops once a day. Precaution measures - use in newborns only as directed by a doctor. Side effects rarely occur, since the drug is plant-based.
4. Antiviral Aflubin has a direct antiviral and interferon-stimulating effect when it is low in toxicity. The dosage of the drug depends on the period of the disease and can be from three drops three times a day up to seven times a day. Side effects can be in the form of allergic reactions.

There are clear indications regarding the appointment of antibiotic therapy for conjunctivitis. In the uncomplicated course of viral inflammation of the eye, antibiotics are not used in connection with possible increased allergization of the organism, suppression of the formation of antiviral antibodies, an increase in the number of complications.

In some cases, the appointment of antibiotics is shown:

• Suspicion of bacterial conjunctivitis;
• Presence of congenital infections in the child;
• Duration of fever without symptoms from other organs;
• Very weakened patients;

Antibacterial agents should be prescribed strictly individually, taking into account the concomitant pathology and possible side reactions. Penicillin is not currently a drug of choice. If you suspect a bacterial process of inflammation, you can use systemic antibiotics or local drops. Drops in the eyes with suppuration can be prescribed only by an ophthalmologist.

Than to wash out eyes to the newborn, if the eye fester? With confidence for the first time, while there is no way to consult a doctor, you can use eye drops Floxal. These are eye drops based on the antibiotic ofloxacin, which has antibacterial properties and prevents further attachment of bacterial infection. Use the drug for several days, one drop to three times a day. Precautions - an open vial can be stored for up to six weeks.

If the newborn is festering due to dacryocystitis, the most optimal method of treatment is surgery. In some newborns, the plug from the canal leaves by itself. When the eyes stop festering in newborns with dacryocystitis. This happens by the end of the second week of the baby's zhizin. If before this period the eyes continue to turn sour, then they start a massage. Massage is carried out by circular movements in the direction from the outer to the inner eyelid of the child. This procedure should be done several times. If the cork does not depart at the same time, then already resort to operational methods. 

Surgical treatment begins with systemic anesthesia. After that, the affected eye is washed with an antiseptic. Then a special thin probe is inserted into the inner edge of the eye and into the nasal cavity in the course of the nasolacrimal canal. The whole secret from the eye passes into the nasal cavity and the canal becomes passable. The procedure is ended by re-instilling the antiseptic.

Physiotherapeutic treatment in acute period is not used. Vitamins can be consumed by a mother with a virus infection in a child, which increases the activity of the enzyme systems of the baby's body and helps in fighting infection.

Alternative treatment

Very often, parents ask themselves the question, than to treat at home, if the newborn is festering with the eye? Naturally, alternative methods of treatment can be used only with the permission of the doctor and at the discretion and responsibility of the parents. But there are some alternative treatments that you can use. First of all, the herbal treatment for eye washing is often used.

1. Infusion of chamomile can be prepared as follows: one bag of chemist's chamomile pour boiling water and insist for three minutes. Next, the infusion should be filtered and cooled to room temperature. Wipe the eyes of the child three times a day, starting from the outside and moving to the inside. Do this with a sterile merleted bandage with caution. If only one glazik is suppurating, then both should be washed.
2. An infusion of flowers of the calendula and calendula helps to remove not only irritation, but also has an antibacterial effect. To make a solution, you need to take 30 grams of calendula flowers and as many cornflowers and pour one liter of boiled water. Insist you need three hours and rub your eyes twice a day against the background of the use of etiological therapy.
3. Aloe has an antibacterial and immunomodulating effect, so when suppuration of the eyes in a baby, the use of aloe is even recommended for better treatment effect. To do this, make fresh juice from aloe and mix with warm boiled water in a ratio of one to one. To wash a glazik it is necessary in the morning and in the evening for five days.
4. For the preparation of medical infusion it is necessary to take several seeds of nightshade and three to four leaves of althea. The mixture should be poured with boiled water and 10 to 12 hours. It is necessary to wash the eyes with this infusion after diluting it in half.

Than to treat, if at the newborn the eye fades after an operative intervention and this condition periodically repeats. In this case, you can use homeopathic remedies that can be used for a long time, taking into account the individual characteristics of each baby.

1. Aconite - an organic drug, which includes processed and diluted extract of aconite, which helps with acute conjunctivitis in children, which is accompanied by a sharp incision in the eyes, reddening of the sclera. The drug can be taken to the newborn in the form of granules. Dosage - three granules five times a day in an acute period. The granule can be crushed and given along with breast milk. Side effects can be in the form of diarrhea, which occurs after several days of regular use of the drug. Precautions - do not use for treatment if the child has an allergic reaction to iodine, since the drug is processed with the addition of iodine.
2. Mercury is a monocomponent homeopathic remedy for the treatment of conjunctivitis, which is used in a chronic process that worsens by evening. The way of application of the preparation is in the form of granules, the dosage for children in the acute period is one granule six times a day, and after the symptoms decrease it can be applied three times a day. Side effects - burning, sneezing, itching in the nasal cavity.
3. Gepar Sulfur is a complex homeopathic medicine that is used to treat conjunctivitis with severe purulent discharge. It can be used in the acute period of adenovirus infection against the background of etiopathogenetic therapy. The method of use for children often in the form of granules. Dosage - 10 granules once a day before meals for five days, with a further break for two days. The course of treatment is about two months. Side effects are very rare, there may be allergic manifestations.
4. Pulsatilla and Arsenic are a combination of homeopathic remedies that help to normalize local protective mechanisms of conjunctiva and reduce the severity of allergic reaction there. For a newborn, the dose is one pellet of pulsatilla and two pellets of arsenics four times a day. Method of application - you can crush the granule and put on the tongue, without washing down with water. Side effects are very rare, but there can be an easy twitching of the muscles, which indicates the need to reduce the dose. The minimum course of treatment is one month.

[36], [37], [38]

Prevention

Prevention of suppuration of the eye in a newborn is first of all proper care of the baby, breastfeeding and avoidance of sources of infection. All this allows us to provide the baby with good immunity and protect him from infections at such a most vulnerable time - in the first month of his life.

Forecast

The prognosis in the treatment of suppuration of the eye is positive, caused by a viral infection or dacryocystitis of the newborn. In most cases, pathologies are immediately identified and actively treated, so complications occur very rarely.

When the eyes of a newborn are festering, this certainly requires the attention not only of the mother, but also of the doctor's advice. This can be caused by inflammation in the eye itself of a viral or bacterial etiology, or the problem may be the age-related violation of the patency of the nasolacrimal canal. In any case, you need adequate treatment and care for the child, then the forecast is very good.