Various ophthalmic problems are associated with eye redness, itching and other negative symptoms. Also, doctors usually pay attention to lacrimation. If it is too abundant, as they say, a person cries “crocodile tears”, they talk about Bogorad’s syndrome. About what such a pathology is and how dangerous it is, told ophthalmologist of the regional hospital (Khimki) Marina Ilyukhina.
“Under this term lies the pathological germination of the fibers of the facial or abducent nerve into the salivary and lacrimal glands. The main manifestation is profuse lacrimation during meals. This condition can be combined with the appearance of skin irritations, increased salivation and photophobia, ”explains Marina Ilyukhina.
The first doctor who described it was a neurologist from Minsk, and it was by his last name that the disease was called. Such lacrimation received its popular name “crocodile tears” for its similarity with the appearance of a symptom in a crocodile at the time of eating its victim. The disease, says Marina Ilyukhina, can be both congenital and acquired.
Why is it developing?
There are many reasons for the development of profuse lacrimation while eating. Among them, the ophthalmologist calls:
- The use of certain medications.
- Iatrogenic effects – for example, when doctors touch nerves during surgery, then Bogorad’s syndrome manifests itself in the postoperative period, less often it can be noted a little later than the intervention.
- Injury – usually abundant tears appear if the integrity of the abducent, superior salivary or facial nerve has been damaged during injury.
- Intrauterine exposure due to toxic drugs, for example if the mother was taking teratogenic drugs. A viral infection during pregnancy can also have an effect.
How to recognize?
“Both forms of the disease are manifested by profuse lacrimation, which is noted when stimulated by food – which does not matter, just as there is no dependence on its taste. In this case, usually solid food leads to a greater flow of tears than liquid. There are situations when tears begin to flow in hail at the mere smell of food, ”explains ophthalmologist Ilyukhina. When the disease progresses, a rash can be seen on the face, and the person will also begin to be afraid of the light.
If the cause lies in the damaged facial nerve, then in parallel there will be a problem with the work of facial muscles. “So, it will be difficult for a person to close his eyes completely, he may notice that his eyebrows and corners of his lips have drooped, while the wrinkles on his forehead will smooth out,” the ophthalmologist warns.
Syndrome in children
If we are talking about the congenital form of the disease, then Bogorad’s syndrome will manifest itself already in childhood. It is easy for parents to suspect him from the first days of a child’s life, the specialist notes. “The child will be quite excitable, in a state of constant irritation. At the same time, he constantly cries. The symptoms manifest themselves most clearly during feeding, ”says Marina Ilyukhina.
Often Bogorad’s syndrome in children is combined with changes – degenerative and dystrophic – of the cornea, bacterial keratitis, the development of lagophthalmos (a violation in the process of closing the eyelids).
Adults can also notice secondary conjunctivitis, hyperkeratosis, which develops due to increased skin irritation against the background of tears, in a severe course of such a pathology.
How is it diagnosed and treated?
If Bogorad syndrome is suspected, the doctor will refer the patient to electroneuromyography (a set of studies for diagnosing diseases of the peripheral nervous system), electromyography (a method for studying local injuries), MRI of the head. In addition, the list of diagnostic measures includes the Schirmer test (checking the amount of tears) and eye biomicroscopy (examination of the eyeball and other structures of the eye under magnification).
The treatment of Bogorad’s syndrome is usually handled by a neurologist. In addition, if necessary, the patient can receive advice from an ophthalmologist and a neurosurgeon, warns Marina Ilyukhina. And the choice of therapy directly depends on the picture of the disease, its form, the course of the disease and the condition of the person.