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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest remedy for streptococcus eye infection in children

Hello, my daughter is 3 and a half months old and has a Streptococcus pneumoniae infection of the left eye, I think that it's in the nasolacrimal canal. We made the necesarry tests, and acording to the antibiogram, the bacteria is sensitive to ciprofloxacin and chloramphenicol. We did 2 week treatment (ciprofloxacin drops during the day and chloramphenicol ointment during the night), but the bacteria keeps coming back :-(. I'm a pharmacist and I really tried everything I know, consulting her pediatrician and ophtalmologist, but no luck! Please help!
Wed, 27 Jan 2016
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General & Family Physician 's  Response
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Unfortunately the Nasolacrimal duct infection keeps coming back as it has a blockage inside which needs to be addressed surgicaalu at the age of 8 to 9 months.But not very late than that.Surgical treatment includes probing and syringing of the duct for mechanical removal of the blockage. Probing failures are treated with more aggressive surgical procedures including balloon dacryoplasty and nasolacrimal duct intubation. Endoscopic dacryocystorhinostomy is generally reserved for intubation and balloon dacryoplasty failures
But before that,the mangement is at home.
Don't use cipro or chloramphenicol too much.Replace it with netilmycin which better in case of NLD infections in infants with less after effects.
Important is to massage the medial side of the eye along the nose with the little finger,where the duct is.Give ten strokes four times a day.This is very effective in removing the blockage with pressure.But don't exert excessive pressure.If it does not work for till 8 months of age,see an ophthalmologist for intervention.
I will be happy to know if you have found answer to your query
Thank you
Dr Faeza Sherdil
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