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患儿男,9岁,3岁始每逢进食右眼流泪,哭闹时左眼流泪,于1994年4月2日来我院就诊。既往无排尿流泪现象,否认有高烧、外伤及重大疾病史。足月顺产第二胎,兄无类似眼疾,父母非近亲结婚,母在孕期无化学药品及放射线接触史。体验:无面瘫,全身未见异常。眼科检查:视力:右5.1。左5.1。双眼无上睑下垂、泪腺肿大及脱垂等,外眼、内眼均正常,眼位正,眼球各方向活动自如。右内眦角相当于内眦韧带下的泪囊面颊部,有一约1 mm× 1 mm大小瘘管,瘘管周无红、肿、热、痛炎性改变,从瘘管不时向外流出少量清液。双泪小点,泪小管无异常。泪道冲洗通畅,但冲洗右眼时,可见从泪囊瘘管内向外流出冲洗液,稍有压力,共流出液清亮无脓性物。
Children male, 9 years old, 3-year-old began to eat the right eye every tear, crying when the left eye tears, in April 2, 1994 came to our hospital. No previous phenomenon of urination and tear, denied a history of high fever, trauma and major diseases. Full-term follow-up of the second child, brother no similar eye disease, parents marry non-relatives, mother during pregnancy without chemical and radiation exposure history. Experience: No facial paralysis, the body did not see abnormalities. Eye examination: visual acuity: right 5.1. Left 5.1. No ptosis of the eyes, lacrimal gland enlargement and prolapse, etc., outside the eye, the inner eye are normal, the eye position is positive, eye movements freely in all directions. The right internal angle corresponds to the dacryocyst cheek of the ligament, with a size of about 1 mm × 1 mm fistula, fistula no red, swollen, hot, pain inflammatory changes from time to time out of the fistula out of a small amount of serum. Double tears, punctate tubules without exception. Lacrimal duct irrigation patency, but when flushing the right eye, we can see from the lacrimal sac fistula outflow of flushing fluid, a little pressure, a total of fluid clear no purulent.