Overview

A dacryocystorhinostomy (DCR) is a surgical procedure that can be used to treat blocked tear ducts. It improves tear drainage by making a new tear duct into the nose, bypassing any existing blockage.

It is usually done under a general anaesthetic as a day case procedure, so you can usually go leave hospital on the same day. 

Causes of blocked tear ducts

Your eyes are constantly producing tears. These usually drain out through the normal tear drainage system, from the inner corner of the eyelid, down the tear duct into the nose. The tear duct narrows with age, resulting in the system overflowing and tears rolling down the cheeks. This can be more noticeable in windy or cold conditions, when more tears are produced.

Other causes of tear duct blockage include facial injuries and some conditions affecting the nose or sinuses. Some people are born with a blocked tear duct.

The entrance to the tear duct can be blocked by other causes, which are not suitable for a DCR.

Diagnosis

You will be seen by a nurse who will do a sight test. Your eye will then be examined by a specialist eye surgeon. They will do more tests, such as:

• flushing salty water through your tear ducts using a fine tube (cannula)
• examining the inside of your nose using a small, thin camera (endoscope)

After discussing your symptoms and treatment options with the surgeon, you might decide to proceed with the surgery. A date for surgery will be arranged and you will see a nurse a for pre-assessment appointment. You might have some routine tests, including blood tests and an electrocardiogram (ECG).

Benefits of a DCR

Your doctor thinks this procedure is likely to reduce your symptoms. DCR surgery is generally very successful, with around 8 in 10 people experiencing a significant improvement in watering of the eye.

Risks of a DCR

A DCR is generally safe. As with any procedure, there are some risks. 

Bruising and swelling

Bruising and swelling is common and can last for a few weeks after surgery.

Infection

An infection in the wound is possible. This risk can be reduced by following the aftercare advice you are given.

Nosebleeds

Nosebleeds can happen up to 10 days after surgery. This happens to 1 or 2 in every 100 people. In most cases, the bleeding will stop by itself. 

Visible incision 

If you have an external DCR, there will be a small incision on the side of your nose. This usually heals well but may be visible until it heals.

More surgery

Occasionally scarring can cause the tear duct to block again, and more surgery may be needed.  In some cases, a small permanent Pyrex^® tube (Jones tube), might need to be surgically inserted to allow the tears to drain. 

Other treatment options

You may decide not to have surgery. You can discuss this in more detail with your doctor.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

Read more about our consent process.

If you wear reading glasses, please bring them with you to help you read the form. If you have reduced vision, you can ask the doctor or a relative to read it to you and check it before you sign.