Also called external DCR. It makes a new passage for tears to drain into the nose, through a small cut beside the nose.
What it is
When the tear duct is blocked, tears spill onto the cheek and the tear sac can become infected. This operation creates a new opening between the tear sac and the nose, bypassing the blockage.
The operation
Through a short cut beside the nose, your surgeon opens a passage into the nose and often places a fine soft tube to keep it open while it heals.
It takes about an hour, under general anaesthetic or local with sedation. The tube is removed at a clinic visit a few weeks later.
What it does not do
Syringing or drops will not clear a blocked duct, though they may help symptoms for a while.
Who it can help
It may suit you if opens a blocked duct so tears drain again is what you notice most, and you are otherwise well.
- Tears running onto the cheek every day
- Repeated infections or a swelling beside the nose
- Sticky discharge, especially in the morning
- A blockage confirmed by syringing
Watering can also be caused by the lid position. Your consultant will check both.
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 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
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
Will there be a scar?
A short scar beside the nose, which usually fades to a fine line.
Is there a way without a scar?
Yes, keyhole tear duct surgery goes through the nose. Your consultant will explain which suits your blockage.
Will the watering stop?
The aim is to give tears a way to drain. Some watering can remain, especially in wind or cold.
Is it covered?
Usually yes. This is medical treatment.