Surgery for Blocked Tear Ducts

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KEY POINTS

• Surgery for blocked tear ducts is a procedure to form a new way for tears to drain. This surgery is done to open the drainage passage to prevent watery eye or repeated eye infections.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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What is surgery for blocked tear ducts?

Surgery for blocked tear ducts is a procedure to form a new way for tears to drain. It is also called a dacryocystorhinostomy or DCR.

When is it used?

Tears are produced by a small gland in your upper eyelid. Each time you blink your eyes, tears move across your eye and drain into tiny holes in the corners of the upper and lower eyelids. The tears then travel through ducts that drain the tears from the eyes into the nose. If the normal drainage passage gets blocked or narrow, you might get a watery eye or repeated eye infections. DCR is done to open the drainage passage.

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Plan for your care and a ride home after the procedure.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Do not wear eye makeup on the day of the surgery.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

You will be given a local or general anesthetic to keep you from feeling pain during the operation. A local anesthetic numbs your nose area while you remain awake. General anesthesia relaxes your muscles and puts you into a deep sleep.

There are 2 ways to unblock the tear duct:

• External DCR. For this procedure, a small cut is made in the side of your nose where a pair of glasses would sit.
• Endoscopic DCR. For this procedure, your provider puts a slim, flexible, lighted tube called an endoscope and instruments into your nose.

For either procedure, the provider will make an opening in the lacrimal sac, which is the top part of the ducts that drain the tears from the eyes into the nose. Tiny silicone tubes are placed in the opening to help it heal in the correct position. If you had external DCR, the provider may use one or more stitches to close the cut.

What happens after the procedure?

You will be in the recovery area after surgery until you are ready to go home. Usually, your provider will advise you to avoid hot food and drinks for the first 12 to 24 hours after surgery. You may also be told to avoid blowing your nose for 1 week to decrease the risk of bleeding. It is normal to have a watery eye for a few weeks after surgery until the swelling goes away.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid
• How to take care of yourself at home and when you can return to your normal activities
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• Problems with anesthesia
• Infection, bleeding, or blood clots
• Rarely, a scar can form inside and block the drain again. You may need another surgery.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.