Tear Duct Surgery (DCR)
When tears do not drain properly, the eye waters constantly. Chronic watering eyes are not just an inconvenience; they signal a blocked tear duct that often requires surgical correction.
Tears are produced by the lacrimal gland and drained from the eye through a small opening at the inner corner of each eyelid into the nasolacrimal duct, which empties into the nose. When that drainage system narrows or blocks, tears overflow onto the cheek, and the area can become chronically inflamed or infected. The condition is called nasolacrimal duct obstruction, and it is the most common surgical cause of watering eyes in adults.
The corrective procedure is a dacryocystorhinostomy, or DCR. It creates a new drainage pathway directly from the tear sac into the nose, bypassing the blocked segment. Dr. Boxrud performs DCR through an external approach or an endoscopic endonasal approach depending on the specifics of each case. Success rates are high.
Watering eyes are easy to ignore, but they are not normal, and they tend to worsen rather than improve. Patients across the Los Angeles area see Dr. Boxrud when their tearing has become a daily issue, when their vision is being blurred by the tear film, or when they have had recurrent infections of the tear sac (dacryocystitis).
- Procedure
- Outpatient, 60 to 90 minutes.
- Anesthesia
- General anesthesia or deep sedation.
- Recovery
- Most patients return to normal activities within a week. A small silicone tube is typically left in place for several weeks and then removed in the office.
What is tear duct surgery?
Tear duct surgery, most commonly known as DCR (dacryocystorhinostomy), opens a new drainage pathway for tears when the natural tear duct is blocked. It is the standard treatment for chronic tearing caused by tear-duct obstruction.
What causes a blocked tear duct?
In adults, age-related narrowing of the tear duct is the most common cause. Other causes include chronic inflammation, prior infections (dacryocystitis), trauma, and previous nasal surgery.
What are the symptoms of a blocked tear duct?
Constant tearing, especially in cold or wind; recurrent infections at the inner corner of the eye (dacryocystitis); discharge; and crusting along the lashes. Symptoms are diagnostic when combined with a tear-drainage exam.
Is tear duct surgery covered by insurance?
Typically yes. DCR is a functional procedure for a medical problem (blocked tear drainage) and is generally covered by insurance.
How long is recovery from DCR?
Most patients return to non-strenuous activity within one week. Some bruising and mild swelling are common; final settling of the result takes several weeks. A small temporary tube is usually placed and removed in the office a few weeks later.
Will I have a visible scar?
External DCR involves a small incision on the side of the nose that heals very well, often becoming nearly invisible. An endonasal (no-skin-incision) approach is also available for selected cases; the decision is made together at consultation.