Also called endoscopic DCR. The same new drainage passage is made through the nose with a small camera, so there is no cut on the skin.
What it is
A blocked tear duct can be bypassed from inside the nose, using an endoscope. It avoids a skin cut and suits many, though not all, blockages.
The operation
A fine camera is passed into the nose, and the passage is opened from the inside. A soft tube usually holds it open while it heals.
It takes about an hour under general anaesthetic, as a day case.
What it does not do
It is not suitable for every blockage. Some need the external operation, or a tube placed permanently.
Who it can help
It may suit you if the same operation through the nose, with no skin scar is what you notice most, and you are otherwise well.
- A watering eye from a blocked duct
- A wish to avoid a skin scar
- Previous tear duct surgery that has closed again
- Nasal anatomy that allows the endoscopic approach
Your consultant will examine your nose as well as your eye before recommending this route.
Recovery and risks
This is a typical course. Your consultant will explain the plan for your own operation and when the tube comes out.
The first two days
Expect some blood-stained tears and a blocked nose. Avoid blowing your nose.
The first week
Bruising around the nose and eye settles. Most people are comfortable at home.
Weeks two to four
You are reviewed in clinic, and the soft tube is removed when your surgeon is ready.
Three months
The passage has healed. Your final review checks that tears are draining.
Possible risks
Every operation carries some risk. For keyhole tear duct surgery these include:
- Nosebleed in the first day or two
- Bruising around the nose and eye
- A small scar beside the nose, where one is needed
- The new passage narrowing again in time
- Infection, which is uncommon
Your surgeon will go through the risks that apply to you, and give you written information to take home.
Insurance
Keyhole tear duct surgery is sometimes covered when the problem affects your health or your vision. Surgery for appearance alone is not.
Check your cover with your insurer before your consultation, and your surgeon will supply what they need.
Questions patients ask
Is it as effective as the external operation?
For many blockages the results are comparable. Your consultant will tell you which route they recommend and why.
Will my nose bleed?
Some bleeding in the first day or two is normal. You will be given instructions and something to use if it starts.
When does the tube come out?
Usually at a clinic visit a few weeks later. It takes a moment and does not need anaesthetic.
Is it covered?
Usually yes. This is medical treatment.