Avgitidou G, Koch K R, Cursiefen C, Heindl L M
Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland,
Ophthalmologe. 2015 Feb;112(2):102-9. doi: 10.1007/s00347-014-3054-8.
During childhood the spectrum of disorders of the eyelid, the lacrimal drainage system and the orbit as well as the subsequent therapeutic management differ from those in adults.
This review outlines the clinical picture and treatment of the most common eyelid, lacrimal drainage and orbital diseases in childhood.
The study comprises a PubMed literature review and own clinical results.
The most common eyelid disorders in childhood include congenital malpositions, such as ptosis or entropium, which may require fast surgical correction in order to prevent amblyopia. For connatal dacryostenosis a step-by-step therapeutic approach is recommended: (1) conservative treatment using lacrimal sac massage, astringent eye and nose drops, (2) irrigation and probing of the nasolacrimal system and (3) irrigation, probing and silastic tube intubation under general anesthesia. Benign orbital lesions such as dermoid cysts can be removed at pre-school age. Using systemic beta blockers is a novel conservative approach in the treatment of capillary hemangioma, which should precede surgical interventions.
Eyelid and orbital diseases during childhood may require fast surgical intervention to prevent amblyopia. Initial conservative treatment is recommended for connatal dacryostenosis and capillary hemangioma.
在儿童时期，眼睑、泪道系统和眼眶疾病的范围以及后续的治疗管理与成人不同。
本综述概述了儿童期最常见的眼睑、泪道和眼眶疾病的临床表现及治疗方法。
该研究包括PubMed文献综述和自身临床结果。
儿童期最常见的眼睑疾病包括先天性位置异常，如睑下垂或睑内翻，可能需要快速手术矫正以预防弱视。对于先天性泪道狭窄，建议采用逐步治疗方法：（1）使用泪囊按摩、收敛性眼药水和滴鼻剂进行保守治疗；（2）鼻泪系统冲洗和探通；（3）全身麻醉下冲洗、探通并插入硅胶管。良性眼眶病变如皮样囊肿可在学龄前切除。使用全身性β受体阻滞剂是治疗毛细血管瘤的一种新型保守方法，应在手术干预之前进行。
儿童期的眼睑和眼眶疾病可能需要快速手术干预以预防弱视。对于先天性泪道狭窄和毛细血管瘤，建议首先进行保守治疗。
