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- Persistent tearing is an aggravating problem that can cause problems with vision or even result in infection
- Tearing can have different causes including problems with the eyelid or the tear drain
- Tear drainage surgery, or DCR, is very effective in most cases and can be performed in an outpatient setting
Persistent tearing can be caused by a variety of issues in and around the eyes. In some patients, the eyes are actually dry, which results in excess tear production with a type of tear that does not stick to the eyeball or keep it adequately lubricated. On other patients, the lower eyelid is not snug to the eyeball, which results in an ineffective blink. This causes the tears to not be able to reach the tear drainage system and instead spill over the cheek. Finally, in many patients, the tear drainage system itself is blocked or clogged. This is a condition called Naso Lacrimal Duct Obstruction (NLDO).
Nasolacrimal duct obstruction is treated with surgery to bypass the blocked portion of the system. The name of this surgery is Dacryocystorhinostomy or DCR for short. In this surgery, the blocked tear drainage system is bypassed to allows tears to exit the eye and prevent tears from rolling down the cheek.
Your surgeon will carefully evaluate the cause of your tearing and may perform tests to evaluate the presence of dry eye, a loose lower eyelid, or a blocked tear drain. Based on this examination, our doctors will provide options for improvement in symptoms.
DCR surgery is typically performed in an outpatient setting under anesthesia. The surgery itself typically takes less than an hour and is not painful. After surgery, in most cases, a silicone stent tube will be placed in the new tear drainage system. This stent tube is typically painless, does not usually cause any irritation or discomfort, nor does it interfere with vision. The stent tube is removed in the office, typically 3 months after surgery. The removal is easy and typically painless.
Post operative care
Patients will be provided with complete post operative insturctions; however, the care after DCR is fairly simple. Most patients will receive a prescription for eyedrops and nasal spray to use for a period of time after surgery. Most patients will be seen 5-7 days after surgery for a post operative visit.
Tear drainage surgery/DCR has a low rate of complications. Infection is very rare, but possible. Some nasal bleeding can occur for 1-3 days after surgery but is usually minimal. As with any surgery, scarring is possible; however, the skin wound typically heals well. In some patients, tearing will persist despite successfully surgery. In these uncommon cases, your surgeon will work with you to find a solution for your tearing.
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