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<ul><li> 1. Case Presentation: Clogged Tear Duct Tonya A. Westerbeke, D.C. Back To Health Chiropractic Wellness Center 10990 Chicago Drive Zeeland, MI49464 616.546.3500</li></ul> <p> 2. Medical Definition </p> <ul><li>Prevents your tear duct from draining naturally </li></ul> <ul><li>Caused by a partial or complete obstruction in the drainage system </li></ul> <ul><li>Up to 20% of newborns have at birth, usually clears within the first year of life </li></ul> <ul><li>Almost always correctable, depends on cause and age </li></ul> <p> 3. Symptoms </p> <ul><li>May be caused by the blocked tear duct or from infection that develops </li></ul> <ul><li>Excessive tearing, watery eyes, recurrent eye inflammation (conjunctivits), recurrent eye infections, painful swelling insode corner of eye, eye mucus discharge, blurred vision, bloody tears </li></ul> <p> 4. How it works </p> <ul><li>Tears come from lacrimal glands, located above each eye </li></ul> <ul><li>Flow down the surface of eye to lubricate and protect, then drain in tiny holes in corner of lids </li></ul> <ul><li>Travel through these canals, and evaporate or reabsorbed </li></ul> <p> 5. How it works cont. </p> <ul><li>Blockage can occur at any point in the drainage system, from puncta to nose. </li></ul> <ul><li>This occurs, tears dont drain properly giving watery eyes and increasing risk of eye infections and inflammation. </li></ul> <p> 6. Causes </p> <ul><li>Congenital Blockage up to 20% newborns </li></ul> <ul><li><ul><li>Drainage system may not be fully developed or duct abnormality </li></ul></li></ul> <ul><li><ul><li>Thin membrane often remains over the opening that empties into the nose (lacrimal duct) in congenitally blocked tear ducts. </li></ul></li></ul> <ul><li><ul><li>Usually opens spontaneously 1 stor 2 ndmonths of life </li></ul></li></ul> <p> 7. Causes cont </p> <ul><li>Abnormal Development of skull or face </li></ul> <ul><li><ul><li>Downs syndrome, increased liklihood of blockage of the tear ducts. </li></ul></li></ul> <ul><li><ul><li>My opinion, but left out in literature search is plagiocephaly </li></ul></li></ul> <ul><li>Chronic eye infections </li></ul> <ul><li><ul><li>Can cause tear ducts to be blocked </li></ul></li></ul> <p> 8. Causes cont. </p> <ul><li>Facial Injuries or trauma sustained by traumatic birthing process could cause bone damage near the drainage system and disrupt the normal flow of tears through the ducts </li></ul> <ul><li>Tumors along the nasal, sinus, or lacrimal sac tumors.Or cysts or stones </li></ul> <p> 9. Complications </p> <ul><li>When not draining tears remain in the drainage system, become stagnant, promoting the growth of bacteria, viruses, and fungi. </li></ul> <ul><li>Organisms lead to recurrent eye infections and inflammation </li></ul> <p> 10. Tests and Diagnosis </p> <ul><li>Tear drainage test (flouorescein dye disappearance test): test drainage, one drop special dye in each eye.If significant amount of dye in eye after 5 min of normal blinking, may have blocked duct </li></ul> <ul><li>Irrigation or probing: fluch saline solution or slender probe inserted </li></ul> <p> 11. Allopathic Treatment </p> <ul><li>Cause determines treatment </li></ul> <ul><li><ul><li>Infection= Antibiotics </li></ul></li></ul> <ul><li><ul><li>Tumor= surgery or recommendations on shrinking </li></ul></li></ul> <ul><li><ul><li>Non-tumor blockage from observation to surgery </li></ul></li></ul> <ul><li><ul><li>Most pts I have encountered, told not to worry until after 1 year then address </li></ul></li></ul> <p> 12. Allopathic treatment cont. </p> <ul><li>After the first couple of months </li></ul> <ul><li><ul><li>Specific massage recommended </li></ul></li></ul> <ul><li><ul><li>Dilation, probing, and irrigation to open congenital blocked tear ducts </li></ul></li></ul> <ul><li><ul><li>Can be done using general anesthesia or restrains in young babies </li></ul></li></ul> <ul><li><ul><li>Punctal openings are enlarged with dilation instrument and probe inserted, pierces thin membrane, popping noise can be heard, probe removed, flushed with saline solution </li></ul></li></ul> <ul><li><ul><li>Balloon catheter dilation, stenting, or intubation </li></ul></li></ul> <p> 13. Chiropractic treatment </p> <ul><li>At this time, no papers were found describing how to assist a patient </li></ul> <p> 14. Case Presentation/History </p> <ul><li>2 week old female presents with inability to burp, (just like her brother), infrequent bowel movements </li></ul> <ul><li>Mother under care during pregnancy, had issue with rib pain </li></ul> <ul><li>Planned C-section, was stuck up under ribs and tried pulling, vacuum used </li></ul> <p> 15. Case Presentation cont. </p> <ul><li>Breast fed, prefers right side, feeding every 30 minutes last night, 2-3 hours day </li></ul> <ul><li>Apgar scored normal 1 &amp; 5 minutes </li></ul> <ul><li>Md told to use Caro syrup for bowel issues, makes baby more uncomfortable </li></ul> <ul><li>Prefers sleep back </li></ul> <p> 16. Case presentation cont </p> <ul><li>After clear up of the initial complaints in 2 visits, the patient continued on wellness care. </li></ul> <ul><li>At 3 months presented for wellness care and noticed copius amounts of mucus in inner eye.Mom admitted she cleans religiously but forgot running behind.MD told to not worry till after 1 year </li></ul> <p> 17. Exam Findings </p> <ul><li>Left parietal overlapping </li></ul> <ul><li>Cone/elongated head </li></ul> <ul><li>Very strong sucking reflex! </li></ul> <ul><li>Parietal and Temporal mis-shaped </li></ul> <ul><li>Muscle spasm noted C1, T1-4, T11&amp;12 </li></ul> <ul><li>Later apt, occipital flattening </li></ul> <p> 18. Treatment</p> <ul><li>Modified Diversified technique:gentle pressure with 3 rdfinger with slight lateral flexion of cspine, thoracic gentle P-A pressure while patient was supine in arms </li></ul> <ul><li>Cranial sacral protocol as taught by Dr. Carol Phillips specific attention to shenoid, ethmoid and occiput </li></ul> <ul><li>No adverse reactions noted </li></ul> <p> 19. Recommendations for care </p> <ul><li>Chiropractic treatment recommended 1 time a week for 4 weeks </li></ul> <ul><li>Home recommendations </li></ul> <ul><li><ul><li>Lacrimal massage </li></ul></li></ul> <ul><li><ul><li>Mimic cranial techniques: sphenoid, ethmoid and occiput </li></ul></li></ul> <ul><li><ul><li>Mom felt it was the occiput technique that was the magic cure saw significan changes when we added </li></ul></li></ul> <p> 20. Recommendations for care </p> <ul><li>Supplements:</li></ul> <ul><li><ul><li>For bowel issues earlier:probiotics </li></ul></li></ul> <ul><li><ul><li>Clogged tear duct:Colloidal silver and follow directions on the bottle </li></ul></li></ul> <ul><li><ul><li><ul><li>Colloidal silver is natures own antibiotic, kills bacteria, viruses and fungus </li></ul></li></ul></li></ul> <ul><li><ul><li><ul><li>Argyria is a condition caused by the ingestion of elemental silver, silver dust or silver compounds which is often linked to colloidal silver </li></ul></li></ul></li></ul> <p> 21. Outcome </p> <ul><li>Condition resloved 100% within 3 chiropractic treatment, mom completing the homework and the supplements recommendations </li></ul> <p> 22. Limitations </p> <ul><li>Of 3 patients that presented with this condition, 2 over the age of one and the parents were not compliant with care and homework and saw no resolution of issue.The one child under 1, and mom completely compliant, resolution of condition. </li></ul> <p> 23. Thank you!</p>


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