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Blocked Tear Duct Surgery

Blocked tear duct surgery, also known as dacryocystorhinostomy (DCR), is a procedure to open up or bypass a blockage in the tear drainage system. The lacrimal sac plays a crucial role in tear drainage by channelling tears from the eye into the nasal cavity. This surgery is often recommended when a tear duct (which drains tears from the eye into the nose) becomes blocked, causing excessive tearing, recurrent infections, or swelling near the inner corner of the eye. Tear duct blockages may occur due to infection, injury, or congenital conditions, leading to discomfort and irritation.

Surgery is performed to relieve these symptoms by creating a new pathway for tears to drain properly, restoring normal tear flow and preventing further complications.

Also known as: Dacryocystorhinostomy, Tear Duct Bypass Surgery

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Everything You Need to Know

Blocked tear duct surgery is a highly effective solution for managing chronic tear duct obstruction, significantly improving a patient’s quality of life. Here are the key benefits of the procedure:

  • Restored Tear Drainage: Surgery allows tears to drain properly, preventing overflow and irritation.
  • Prevention of Infections: Resolving the blockage reduces the risk of recurrent infections and inflammation.
  • Improved Eye Comfort: By restoring normal tear flow, patients experience reduced discomfort, tearing, and swelling.

Most patients experience significant relief following surgery, with a relatively quick recovery period. Ophthalmic plastic surgery is crucial in ensuring successful outcomes for blocked tear duct surgery, often involving collaboration between ophthalmic plastic surgeons and other surgical professionals.

Understanding Blocked Tear Ducts

A blocked tear duct, also known as nasolacrimal duct obstruction, occurs when the tear ducts become obstructed, preventing tears from draining properly from the eye into the nasal cavity. This condition can lead to various symptoms, including excessive eye watering, crusting around the eye, redness, swelling, and discharge or pus from the eye.

In some cases, a blocked tear duct is caused by a thin tissue membrane that remains over the opening that empties into the nose, known as the nasolacrimal duct. Other causes can include facial injuries, infections, tumours, and scarring or inflammation. Understanding these underlying factors is crucial for determining the appropriate treatment and managing the symptoms effectively.

What Causes Nasolacrimal Duct Obstruction?

A blocked tear duct can be caused by various factors, including infection, injury, or age-related narrowing of the tear drainage system. In some cases, it may be a congenital condition, present from birth. Tear duct blockages prevent the normal flow of tears into the nasal cavity, leading to symptoms like excessive tearing (epiphora), recurrent eye infections, and swelling near the inner corner of the eye. In congenital cases, the condition may improve as the drainage system matures. Without treatment, the blockage can cause further complications, such as chronic infections or damage to the tear ducts.

Before Surgery

Consultation

During your consultation, your doctor will review your medical history and symptoms, and may perform tests such as a tear duct irrigation or imaging (e.g., a dacryocystogram) to assess the severity of the blockage. The consultation will also cover the surgical options available to you, including dacryocystorhinostomy, which is the most common procedure to treat blocked tear ducts. Another surgical option that may be discussed is balloon catheter dilation, which involves inserting a thin catheter with an inflatable balloon into the tear duct to widen the passage and restore normal tear drainage.

Procedure Instructions

Before surgery, you will receive specific instructions from your doctor. These may include:

  • Medication Adjustments: You may need to stop taking certain medications, such as blood thinners, a few days before surgery.
  • Fasting: If general anaesthesia is used, you will need to fast from midnight before the day of surgery.
  • Pre-Op Preparations: It’s advisable to maintain a healthy lifestyle leading up to the surgery, including stopping smoking if applicable, to ensure the best recovery outcomes.
  • Nasal Decongestant Spray: Using a nasal decongestant spray can help prevent infection and reduce inflammation, especially if you are undergoing procedures like dacryocystorhinostomy.

Your doctor will provide you with all necessary pre-operative guidelines during the consultation.

Benefits of Blocked Tear Duct Surgery

Blocked tear duct surgery, or dacryocystorhinostomy (DCR), offers numerous benefits for those suffering from tear duct blockages. By creating a new pathway for tears to drain between the eyes and the nose, this procedure can provide significant relief from the symptoms of a blocked tear duct, such as excessive eye watering and crusting around the eye. Improved tear drainage reduces the risk of recurrent infections and other complications, such as dry eye and nasal congestion. Patients often experience a marked improvement in their quality of life and a reduction in discomfort, making this surgery a highly effective solution for managing tear duct blockages.

During the Surgery

Our experienced surgeons use advanced techniques to provide the best outcomes and ensure patient comfort throughout the procedure.

Anaesthesia

Blocked tear duct surgery is typically performed under general anaesthesia or local anaesthesia with sedation, depending on the complexity of the surgery and the patient’s medical needs. The doctor will discuss which option is best for you during your consultation.

Surgical Process for Dacryocystorhinostomy (DCR)

The most common procedure for treating a blocked tear duct is dacryocystorhinostomy (DCR). During this surgery, the surgeon creates a new passageway between the tear sac and the nasal cavity to allow tears to drain directly into the nose. This bypasses the blocked portion of the tear duct. In some cases, a thin tube (stent) may be temporarily placed to keep the new pathway open as it heals.

The surgery usually takes around 60 to 90 minutes, and most patients can go home the same day.

After Surgery

Immediate Post-Op Care

After surgery, your eye may feel sore or swollen for a few days. You will be given antibiotic eye drops or ointment to prevent infection and reduce inflammation. Mild bruising around the eye is normal, and you may also experience some nasal congestion or bleeding. It’s important to avoid blowing your nose for about a week to prevent pressure on the new tear duct opening.

Long-Term Recovery

Your surgeon will schedule a follow-up appointment within a few weeks to check the healing process and, if necessary, remove the stent used to keep the new tear drainage pathway open. During the recovery period, you should avoid strenuous activities and bending over, which can increase pressure in the nasal area. Full recovery typically takes four to six weeks, and during this time, your doctor will monitor your progress to ensure that the tear duct is functioning correctly. Recovery times may vary depending on whether an external surgery or an endoscopic approach was used.

Risks and Complications

As with any surgical procedure, blocked tear duct surgery carries certain risks and potential complications. These can include bleeding and infection, scarring, and dry eye. Some patients may experience nasal congestion and sinusitis following the surgery. In rare cases, the procedure may not fully relieve the symptoms, necessitating additional surgery or procedures. It’s important to have a thorough discussion with an ophthalmic plastic surgeon or an ophthalmologist to understand these risks and weigh them against the benefits. This will help determine if blocked tear duct surgery is the right option for you, ensuring you make an informed decision about your treatment.

Appointment and Treatment Plan

01

Initial Consultation

Your journey begins with an initial consultation where your tear duct blockage will be assessed, and a personalised treatment plan will be developed based on your symptoms and medical history.

02

The Procedure

The surgery will be performed under either general or local anaesthesia, with the aim of restoring normal tear drainage and improving eye comfort.

03

The Follow Up

Post-surgery, regular follow-up appointments will ensure that your eye is healing properly and that the new tear drainage system is functioning as expected.

Top Tips

  • Avoid Nose Blowing: Refrain from blowing your nose for at least a week to prevent disruption of the new tear duct pathway.
  • Follow Post-Op Instructions: Use the prescribed eye drops and ointments as directed to reduce the risk of infection.
  • Rest and Recover: Take it easy and avoid heavy lifting or strenuous activities during the first few weeks post-surgery.
  • Attend Follow-Up Appointments: Regular check-ups are crucial to ensure proper healing and success of the procedure.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.