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Tear Drain Surgery

Tearing of the eyes is extremely common in young and old alike. Tearing may result from numerous different causes spanning from the eye to the nose. Tearing due to a blockage in the tear drainage system may cause relentless, bothersome tearing that often runs down the face. The tear drain is composed of channels that run from holes in the eyelid down into the nose. An obstruction in any of these structures may require surgery to cure the problem.

One of the most common blockages in the tear drain system is called nasolacrimal duct obstruction. Nasolacrimal duct obstruction can be caused by age, infections, medications, and trauma. The diagnosis of nasolacrimal duct obstruction is made in clinic with testing including irrigation of the tear drain and visualizing the structures in the nose.

When tearing does not resolve with medications, surgery may be necessary. One of the most common surgeries to help with tearing is called a dacryocystorhinostomy, or DCR for short. A DCR surgery is performed to create a new tear drain pathway, bypassing the obstruction in the nasolacrimal duct. The surgery may be performed entirely in the nose with no skin scar or through a well-hidden incision on the side of the nose. Regardless of the cause of tearing, Dr. Sweeney and Dr. McDevitt will evaluate you in clinic and help you determine which treatment is best for you. Many tear-related procedures can be performed in our office surgical suite, however, a DCR surgery is performed in the hospital operating room. Patients can return home immediately after the procedure and resume nearly all normal daily activities the next day. After tear drain surgery, there is minimal downtime and you can expect 90% of the bruising and swelling to resolve by two weeks.

Tearing itself is not a medically dangerous condition, however, it can decrease the quality of your vision and be bothersome to your daily life. Occasionally constant dabbing of the eyes with tissues can cause allergies or skin breakdown. Some patients will develop blockage in the tear drain that can lead to infection of stagnant fluid, which does require surgical intervention to cure. Regardless of the cause of tearing, Dr. Sweeney and Dr. McDevitt will evaluate you in clinic and help you determine which treatment is best for you.

When tearing becomes distracting to daily life and the cause is a blocked tear duct, usually a tear drain surgery will be covered by an insurance company. Dr. McDevitt and Dr. Sweeney will evaluate you for your tearing and help determine what the cause of the tearing is and if you meet the criteria of insurance-covered surgery.

Depending on the surgery you undergo for tearing, the success rates of surgery can be as high as 95%. Occasionally, tearing may return due to ongoing clogging of the tear drain from the same or a different problem. If this occurs, generally the procedure to remove the obstruction is far less burdensome than the original intervention.

DCR is typically a well-tolerated surgery with minimal to no downtime. The surgery primarily entails work in the nose, which is not visualized by the patient after surgery. While a DCR surgery can be performed in a minimally invasive strategy, all techniques of DCR have potential risks. Patients may expect mild pain for 2 days after surgery or a light nose bleed for 6-12 hours after surgery. In experienced hands, such as Dr. McDevitt and Dr. Sweeney’s, major risks of DCR are very rare.