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Tears and Lacrimal Duct Problems | DCR Surgery

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What is DCR Surgery for Tears and Tear Duct Problems?

What is Tear Duct Obstruction and DCR Surgery?

A blocked tear duct is a condition that prevents tears from draining normally toward the nose. This can lead to constant watering of the eyes (epiphora), blurred vision, stinging, redness, and even infections. If left untreated, it can seriously impact quality of life.

Tear duct obstruction is usually treated with a surgical procedure called dacryocystorhinostomy (DCR). This surgery bypasses the blocked tear duct, creating a new drainage pathway and allowing tears to drain naturally into the nose.

What Causes Tear Duct Obstruction?

Tear duct obstruction can have many causes:

  • Advanced ageTear ducts may narrow with age.

  • Chronic inflammations: Especially conditions such as eyelid inflammation (blepharitis) and sinusitis.

  • Traumas and injuriesAfter blows or surgeries around the eyes.

  • TumorsAlthough rare, a tumor may form in or around the canal.

  • Congenital causes: Tear duct obstruction is common in babies.

What are the causes of eyelid retraction?

Eyelid retraction has various causes. This condition can be congenital, but it can also be caused by thyroid disease (Graves' disease), trauma, and previous surgery. Thyroid disease is the most common cause of upper eyelid retraction. Lower eyelid retraction is most often caused by complications arising from lower blepharoplasty (under-eye aesthetics). This condition can be triggered by excessive skin removal or scarring. Additionally, large eyes or a significantly protruding eye (negative orbital vector) can also cause the lower eyelid to droop too much.

Causes of Excessive Eye Watering

Not every watery eye indicates a blocked tear duct. Dry eye syndrome, in particular, can paradoxically cause excessive tearing. When the eye surface is insufficiently moistened, the brain signals increased tear production, causing temporary but intense watering. Similarly, eyelid abnormalities, such as the lower eyelid turning outward (ectropion) or turning inward (entropion), can cause tear leakage. Such structural problems often require surgical intervention.

If the underlying problem is a blockage in the tear drainage system—the ducts that carry tears to the nasal cavity—the treatment approach is different. In this case, the most effective solution is DCR (dacryocystorhinostomy), a surgical procedure that bypasses the blockage.

What is DCR Surgery for Tears and Tear Duct Problems?

What is DCR Surgery (Dacryocystorhinostomy)?

DCR surgery is a surgical procedure performed to permanently resolve a blockage in the tear duct. This procedure bypasses the blockage, creating an alternative pathway for tears to flow back into the nose. Traditionally, this procedure was performed through a small incision in the skin between the eye and nose. However, today, thanks to the endoscopic (endonasal) method, the procedure is performed through the nose, leaving no external scars, and the recovery process is quite comfortable.

The surgery is usually performed under local anesthesia and takes 30-60 minutes. A temporary silicone stent may need to be placed to keep the new tear duct open. These stents are removed under a doctor's supervision within a few weeks or months. After endoscopic DCR surgery, patients are usually discharged the same day and can return to their normal routine within a few days.

Things to Consider After Surgery

A mild runny nose or watery eyes can often be observed after DCR surgery. These are temporary symptoms. It is important for patients to regularly use eye drops and nasal sprays recommended by their doctor, avoid harsh blows to the nose, and regularly attend follow-up appointments. Maintaining good eye and nasal hygiene, especially during the first week, reduces the risk of infection.

Because there are no external incisions in endoscopic surgeries, recovery is much quicker and scarless. This is a significant advantage for patients concerned about aesthetics.

Frequently Asked Questions

In adults, it usually doesn't go away. If left untreated, chronic watering, infection, and discomfort will persist.

 

No. Because it is performed under local anesthesia, there is no pain. There may be some slight tenderness afterward.

 

When performed with the endoscopic method, there are no visible scars from the outside.

 

In rare cases, it can recur. In such cases, the problem can be resolved with revision surgery.