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Nasolacrimal Duct Blockade in a Calf and Its Successful Management-A Case Report

Shahid Hussain Dar Mujeeb Rehman Fazili Dil Mohammad Makhdoomi shazia Nissar
Vol 2(2), 261-262
DOI-

A 3 months old male calf was presented in the Teaching and Veterinary Clinical Service Complex, F.V.Sc and A.H, SKUAST-Kashmir, with the history of epiphora from right eye from few weeks. Naso lacrimal duct was flushed and fine 2-0 nylon suture was passed through nasolacrimal ductand it was repeated for few daysand along with drops of antibiotic and dexamethasone. After few days, the animal recovered fully.


Keywords : Epiphora Naso Lacrimal duct nylon suture dexamethasone

Introduction

The tear film actively and passively protects the cornea andconjunctiva (it contains e.g. lysozyme, lactoferrin, IgA, IgMand IgE),(German et al., 1998 andDavidson andKuonen, 2004)keeps them clean, moist and lubricated, suppliedwith nutrients, and transports white blood cells. The tear film is approximately 0.04–0.07 mmthick and consists of three layers (Prydaland Campbell, 1992).Approximately 25% of the precorneal tear film is lost by evaporation. The remainder passes into the puncta and via the canaliculi, sac, and duct to the nasal cavity. A large proportionof the precorneal tear film accumulates in the inferior fornix as the lacrimal lake. Most of this fluid enters the inferior punctum through capillary attraction and movements of the lids. Obstruction or compression along the path of drainage and/or overproduction of tear fluid quickly leads to epiphora and tear stripe formation.This paper presents a rare case of lacrimal blockade in a calf and its successful management.

History, Clinical Signs and Treatment

A 3 months old male calf was presented in the Teaching and Veterinary Clinical Service Complex, F.V.Sc and A.H, SKUAST-Kashmir, with the history of epiphora from right eye from few weeks. The calf was already treated by local veterinarian with topical antibiotic but the condition didn’t improved. Onclinical examination patient was having profuse lacrimation from right eye. Physiological parameters were normal. Animal was sedated with xylazine 0.05 mg/kg IM and Canula was introduced into the upper lacrimal puncta first and the lower puncta was blocked by pressing it with finger and normal saline was pushed with the help of 20 ml syringe into it. Then same procedure was done to the lower puncta. Large amount of pus material came out through the punctas. Then finally block opened and then 1-0 No. nylon suture material was introduced through upperpunctaand then lower until came out through nostrils via ostium nasolacrimal duct. The same procedure was repeated again next few days. Antibiotic gentamycin with dexamethasone eye drops was introduced into punta after every flushing of it and also prescribed for eye drops thrice a day for 7 days. After few days the condition resolved totally.

Discussion

Obstructions to drainage may be due to congenital or acquired disorders. The most common congenital disorders of the nasolacrimal system are an imperforate or micropuncta (especially of the lower lid).Acquired disorders include traumatic laceration of the nasolacrimal system; inflammation, i.e., dacryocystitis; foreign bodies lodged in the nasolacrimal system; or external compression of the nasolacrimal system by bone fractures, cellulitis or neoplasia in the surrounding tissue.

Dacryocystitis is inflammation within the lacrimal sac and nasolacrimal duct. It occurs most frequently in dogs and cats and less frequently in horses. Although foreign bodies (e.g.,grass awns, sand, dirt, and concretions of mucopurulent material) can be expressed in some patients, the primary cause is often undetermined (Paul, 2008 andStades et al., 2007). In the present case mucopurulent material came out while flushing ofcanaculi which suggested the probable cause for the epiphora as suggested by the Paul, 2008 and  Stades et al., 2007.

Patency of lacrimal puncta was checked through canulation and passing of nylon through the puncta as recommended by Paul, 2008 and Stades et al. 2007.While flushing antibiotic and dexamethasone drops was introduced into lacrimal duct. Antibiotic and dexamethasone ophthalmic eye drops was also prescribed for one week for the prevention of inflammation (Paul, 2008 and Stades et al. 2007). The nasolacrimal blockade in calves is less documented as compared to other species.

References

Davidson, H.J. andKuonen, V.J.2004.The tear film and ocular mucins.Vet. Ophthalmol.7: 71.

German, A.J., Hall, E.J. and Day, M.J.1998. Measurement of IgG, IgM, and IgA       concentrations in canine serum, saliva, tears and bile.Vet. Imm. Immunopath. 64:        107.

Lundvall, R.L. and Carter, J.D. 1971.Atresia of the nasolacrimal meatus in the horse.JAm.Vet.Med. Assoc. 159: 289.

Paul, E. M. 2008. Lacrimal System In: Slatter’s Fundamentals of Veterinary Ophthalmology, edn. 4th, Saunders, Elsevier. pp. 156-174

Prydal, J.I. andCampbell, F.W. 1992. Study of precorneal tear film thickness and structure  by interferometry and confocal microscopy.Invest. Ophthalmol. Vis. Sci, 33: 1996.

Ron Ofri. 2008. Lacrimal System and Third Eyelid Diseases. OphthalmologyScientific  Proceedings: Companion Animals Programme.  Abstracts European Veterinary             Conference Voorjaarsdagen. 177-178.

Stades, F.C.., Wyman,M., Boeve,M.H., Neumann, W.andSpiess,B. 2007. Lacrimal  apparatus, In:  Ophthalmology for The Veterinary Practitioner, 2nd edition, 59—71.

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