Dacryocystorhinostomy (DCR)
This page gives you information about the operation for a blocked tear duct called Dacryocystorhinostomy (DCR) including what to expect and the possible complications.
What is DCR surgery?
A DCR is an abbreviation for dacryocystorhinostomy. It is an operation carried out on people with watering eyes, due to a blocked tear duct.
Tears are made naturally by our bodies to keep the eye moist, healthy and comfortable. With each blink, your tears are drained away from the eye through two small holes in the upper and lower lids. From here the tears pass along very small tubes, collecting in the tear sac to the side of the nose. They then pass down a tube (or duct) into the nose, finally draining away into the back of your throat (see figure 1 within the PDF below).
If any part of this drainage pathway is blocked, the eye will water. This may happen in children or in the elderly. The only effective treatment of any blockage is an operation.
Symptoms
- A watery eye
- A painless swelling near the nose, called a mucocele. Firm pressure on this swelling causes a white mucous to appear in the tears. This mucocele can also become infected and painful
Tests
Syringing - salt water is flushed through the tear duct. Normally this fluid will pass into the throat and is swallowed. If there is a blockage, the water has nowhere to drain and spills out onto the cheek.
Probing - a very fine probe can usually be passed through the tear duct into the tear sac. If we cannot manage this, there is most likely a blockage there.
The DCR operation
This is usually carried out under general anaesthetic, while you are asleep. A small cut is made to the side of your nose over the tear sac. We will make a new direct path through bone from the tear sac into your nose. Silicone tubing is then placed in this new path and left in place for at least 6 weeks to make sure that scar tissue does not close it again. With the tube in place your eye may continue to water, but if the operation has been successful this will stop when the tube is removed.
The tube will be removed during an outpatient clinic appointment usually 6 weeks after the DCR operation.
Complications of surgery
Scarring - there will be a small scar on the side of your nose where the cut was made. This normally fades within 6 months.
Bleeding - you may notice bleeding from your nose. If this starts to become heavy or lasts longer than 20 minutes, please contact your local Minor Injuries Unit or Emergency Department.
Eye keeps on watering - 1 in 10 of these operations does not solve the problem. The operation may need to be carried out again and the tubes reinserted.
Contact information
If you have any queries or problems immediately after the operation, please contact the:
Casualty Eye Line
Tel: 0300 422 3578
Available 24 hours a day
If you cannot attend the date given to you for your surgery, please inform the:
Admissions Office
Tel: 0300 422 4001
Monday to Friday, 8:00am to 4:00pm