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Drain Tear Ducts Surgically with Dacryocystorhinostomy

Published on May 4, 2017

Tear ducts or lacrimal sacs are responsible for draining tears from your eyes. A blocked or malfunctioning tear duct leads to the over production of tears, infection of the drainage system, or a shortage of tears.

Functioning tear ducts are critical for eye health as they keep the eyeball hydrated and prevent foreign objects from damaging the eye. A Dacryocystorhinostomy (DCR) is the most common surgery used to fix a malfunctioning or infected tear duct.

Causes and Symptoms

The most common causes for a tear duct blockage are aging, inflammation, dirt particles, infections, previous surgeries, tumors, and in rare cases, cancer treatments. There are no immediate indicators of a tear duct blockage but they show up over time.

In some cases, the blockage will clear out by itself over time. Symptoms of a tear duct blockage include over-tearing, redness of the eye, swelling, blurred vision, recurrent infections, and eye discharge.

Diagnosis

Diagnosing a tear duct blockage is tricky as many patients will notice the symptoms but fail to make the connection towards a blocked tear duct. If a doctor suspects a tear duct blockage, he will perform a simple test to observe drainage.

A single drop of a dyed substance is put on the eye and the level of absorption is noted. Other methods of diagnosis include probing, where a thin tube is placed within the lacrimal system and a saline fluid is passed through it to observe drainage. Common tests like MRIs, CT scans, and X-rays are also used to determine the presence of a blocked tear duct.

Types of DCR

There are two ways in which a Dacryocystorhinostomy surgery is performed – external and endoscopic. During an external DCR, your will surgeon make a small incision between the corner of the eye and the bridge of the nose. A small piece of the nasal bone is removed to create a small hole that directly connects the tear sac and the interior of the nose. Thus, a new drainage system is created.

During an endoscopic Dacryocystorhinostomy, your doctor will insert a small, thin tube into the tear duct opening at the corner of the eyelid. An endoscope is then inserted through the nostril and an incision is made at the point where the tube meets the blocked tear duct. A new pathway is thus created for the drainage of tears.

A DCR is a one day procedure and is typically performed using local anesthesia or complete sedation. An endoscopic DCR is preferred to a traditional one as there is no scarring. Scarring is very minimal even during an external DCR. Both procedures have relatively short recovery times.

Recovery

After the procedure, patients are prohibited from blowing their nose for a few days, in order to prevent nasal bleeding. It is also important to avoid demanding physical activity for a couple of days after the surgery and keep the inside the nostril moist.

In case of mucous, nasal drops can be used to clear it instead of blowing. Typically, small amounts of blood is discharged for up to two or three weeks after the surgery. If the bleeding persists or increases, it is vital to contact your doctor immediately.

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Contact our office to schedule a consultation with Dr. Jeffrey Joseph, a board-certified ophthalmic reconstructive plastic surgeon. He will assess your needs and address any of the concerns you have. If you make a good candidate, he will develop a customized plan to help you find relief.

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