Normally, tears are produced in the outer part of the eye socket and lubricate the eye as they course towards their normal drainage areas into the nose, in the inner part of your upper and lower eye lids. The tears then flow through a long duct on the outer parts of the nose, and drain close to the nasal floor, where they flow with the normal nasal mucus secretions to the back of the nose.
A blocked tear duct has a variety of potential causes, including:
- Anatomical, congenital (present at birth) problems
- Chronic nasal infections
- Conjunctivitis (“pink eye”)
- Hormonal conditions
- Nose polyps
- Obstruction from a tumor
- Trauma to the nose
An endoscopic dacryocystorhinostomy (DCR) is a surgical procedure that is done to create an alternative tear drainage between your eyes and nose. Prior to doing it endoscopically, the procedure was done through an incision in the face adjacent to the upper part of the nose. However, today it can be performed through the nostrils in a minimally-invasive manner utilizing a nasal endoscope.
An endoscopic DCR bypasses this normal drainage pathway when it becomes blocked, due to a variety of reasons. A DCR allows the tears to flow directly into the nose. This bypass is constructed higher up in the nose, above the obstructed area in the lacrimal duct, in the area of the lacrimal sac.
Who is a Candidate?
Your specialist will recommend that you undergo a DCR to relieve the symptoms of a blocked tear duct, which can include excessive eye watering or crusting around the eye. If your tear duct is infected, you may also be experiencing:
- Swelling and tenderness around your eye
- Eye irritation
- Mucus discharge
It’s important to realize that not everyone who has a blocked tear duct will need to undergo a DCR. Speak with your specialist to determine the best treatment option for your blocked tear duct.
What to Expect
For this procedure, you will be under general anesthesia (fully asleep) in an outpatient setting. Using a nasal endoscope, your surgeon creates a small opening through your nostril, in the outer part of the nose (inner part of the lacrimal sac that lies above the obstructed duct). This opening connects your lacrimal sac (area where tears over flow from the upper and lower lid areas) to your nasal cavity, creating a new path for tears to drain into your nose. Sometimes, the surgeon may leave a small tube in place for six weeks to help keep the new tear duct open, if there is a lot of internal inflammation or scarring of the sac.
Why Choose UHealth?
Ranked No. 28 in the nation according to U.S. News & World Report. The ranking reflects the team’s dedication to excellence in research patient care and outcomes. Surgeons, audiologists, biomedical engineers, speech pathologists, researchers, and psychologists collaborate with many research programs at the University of Miami Miller School of Medicine to deliver the best possible multidisciplinary care to pediatric and adult ear, nose, and throat patients.
Experienced, specially trained experts. The experts at University of Miami Health have over 30 years of experience performing endoscopic DCR, endoscopic orbital decompression, and other transnasal endoscopic orbital procedures to remove tumors of the orbit through the nose. They are part of a well-trained group of internationally recognized endoscopic transorbital surgeons that work together daily, as an integrated multidisciplinary team of ENT doctors and ophthalmologists (at our world-renowned Bascom Palmer Eye Institute) who specialize in endoscopic transnasal procedures of the orbit. You receive individualized care as our team determines the cause of your excessive tearing (epiphora) and determines the best evidence-based treatment plan (medical or surgical) for your problem.
Our academic health center provides you with more treatment options. Our ENT specialists are experts in the field of rhinology. As part of an academic health center, we are proud to offer breakthrough treatments not available to other facilities in South Florida. We also offer our patients early access to clinical trials and new medical and procedural treatments. We provide comprehensive care for a wide array of rhinologic conditions, backed by expertise, research, and education.
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