When the tear duct is blocked, your tears back up and spill over your eyelids as if you were crying (watery eyes).
Tears trapped in the tear sac can become stagnant and infected. The most common symptoms are excessive watering, mucous discharge, eye irritation, and painful swelling in the inner corner of your eyelids. If your symptoms go untreated, an infection can develop around the eye.
Dr. Maleki and Dr. Oestreicher may recommend a number of treatments, based on the analysis of your symptoms. In some instances, it may be as simple as applying warm compresses and antibiotics, but often surgery is the most effective treatment.
The most common surgical solution is the dacryocystorhinostomy (DCR). Since its introduction in the early 1900s, the procedure has the highest success rate (more than 90%) for adults who have not had prior nasal surgery or disease. To perform the procedure, Dr. Maleki or Dr. Oestreicher will create a new tear drain opening from the blocked sac directly into your nose to bypass the obstruction. A small incision is made either in the skin or inside the nose.
A fine, soft silicone stent may temporarily be left in the new tear drain (for six – eight weeks) to keep the duct open while healing occurs. For a very small number of patients, it may be necessary to surgically place a tiny artificial drain called a “Jones tube” behind the inner corner of the eyelids. The tube is made of Pyrex glass and remains permanently in the tear duct.
Most patients experience resolution of their tearing and discharge once surgery is completed, with little, if any, postoperative discomfort.
In addition to the removal of the sutures, minor bruising or swelling may be expected and will likely go away in one to two weeks. Occasionally, scar tissue may form, blocking the drain again, which may require repeating the procedure.
Children are frequently born with an obstruction within the “tear pipe”. When this occurs, tearing, or watery eyes, results. The stagnant tears within the “tear pipe” often become infected causing pus (heavy matter) to collect between the eyelids. Such obstructions may dissolve on their own within the first few months of life. It not, ophthalmic reconstructive surgery can eliminate this problem with refined surgical techniques.
Bleeding and infection, which are potential risks with any surgery, are very uncommon. As with any medical procedure, there may be other inherent risks that should be discussed with Dr. Maleki or Dr. Oestreicher.
Your surgery will be performed by Dr. Maleki or Dr. Oestreicher, board certified ophthalmologists with extensive training in ophthalmic plastic surgery and published work in the world’s largest academic series on vascularizing enucleation implants.