Lacrimal surgery (DCR) for watery eyes
Endoscopic surgery to relieve a constantly watering eye caused by a blocked tear duct.
A dacryocystorhinostomy (DCR) treats a constantly watering eye caused by a blocked tear duct. Tears normally drain from the inner corner of the eyelids, through narrow tubes into a small tear sac, and then into the nose. If these tubes are narrowed or blocked the tears cannot drain and the eye waters. A DCR bypasses the blockage by making a new opening from the tear sac into the nose.
What it involves
- Mr Gane performs it endonasally, entirely from inside the nose, so there is no cut or scar on the face (an external approach also exists and is discussed where appropriate)
- Under general anaesthetic, usually about 45 minutes per side
- Fine silicone tubes (stents) are placed at the corner of the eye, running into the nose, and stay in for about 6 weeks to 3 months before removal in clinic
- A day case; you go home with an eye pad that comes off the next day
Recovery
- A little bleeding from the front of the nose is normal; heavier bleeding occurs in 1 to 2% of cases
- Avoid very hot food and drink for the first 24 hours
- Do not blow your nose for up to 10 days; use a saline nasal wash instead
- Avoid aspirin; use paracetamol or ibuprofen if needed, though it is not usually painful
- Eye drops, and sometimes a steroid nasal spray, are used at home
Follow-up and risks
You are reviewed at about three weeks to check the nose, and again around six weeks to remove the stents. The watering often improves straight away but can persist until the tubes are out. The main risk is failure, where scarring re-blocks the drainage and the eye keeps watering, sometimes needing further surgery; a loose lower eyelid can also contribute. The eye can feel dry or gritty afterwards, which lubricating drops help.
Before surgery, stop blood thinners such as aspirin, regular ibuprofen, diclofenac or clopidogrel for two weeks. Anticoagulants such as warfarin or rivaroxaban need a plan agreed with your GP or anticoagulant clinic.
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This page is general information and not a substitute for individual medical advice. The right treatment depends on your assessment.