Dacryocystorhinostomy (pronounced dak-ree-o-sis-toe-ry-nost-o-mee) or DCR, is a surgery performed to correct a blocked or obstructed tear duct. The tear duct is a passageway from the eye to the nose that facilitates the drainage of tears.

Tears are essential to lubricate and protect the health of the eye. With each blink, the eyelids act as windshield wipers, evenly spreading tears across the eyes’ surface. The tears then drain into small openings on the inside corner of the eyelids, called puncta and travel to the lacrimal sac. From the lacrimal sac, they flow through the lacrimal duct and empty into the nose. If tears become trapped in the lacrimal passageway there is a risk of infection. A DCR can be performed to correct this problem.

What are the Symptoms of an Obstructed Tear Duct?

If the tear passageways become blocked, tears cannot drain properly and may overflow from the eyelids onto the face as if you were crying. In addition to excessive tearing you may also experience mucous discharge, eye irritation, and painful swelling in the inner corner of the eyelids. A thorough examination by an ophthalmologist can determine the cause of tearing and recommended treatment.

How is it an Obstructed Tear Duct Treated or Repaired?

Depending on your symptoms and their severity, your specialist will suggest an appropriate course. In mild cases, a simple treatment of warm compresses and antibiotics may be recommended. In more severe cases, DCR surgery is the most effective treatment. A DCR is performed by creating a new tear passageway from the lacrimal sac to the nose, bypassing the obstruction. A small incision is made either in the skin or inside the nose. A small silicone tube called a stent may temporarily be left in the new passageway to keep it open during the healing process.

In a small percentage of cases, the obstruction is between the puncta and the lacrimal sac. In these cases, in addition to the DCR procedure, the surgeon will insert a tiny artificial tear drain called a Jones Tube. A Jones Tube is made of Pyrex glass and allows tears to drain directly from the eye to the lacrimal sac.

Where is the Surgery Performed?

DCR surgery is usually performed as an outpatient procedure under local anesthesia. There is very little postoperative discomfort and any bruising and swelling subside in one to two weeks. Most patients experience an immediate resolution of their tearing and discharge problems once surgery and recovery are completed.

Who Should Perform DCR Surgery?

When choosing a surgeon to perform a dacryocystorhinostomy or DCR, look for an ophthalmic plastic reconstructive and cosmetic surgeon who specializes in the eyelids, orbit, and tear drain system. It’s also important that he or she has completed an American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) fellowship. This indicates your surgeon is not only a board certified ophthalmologist who knows the anatomy and structure of the eyelids and orbit, but also has had extensive training in ophthalmic plastic reconstructive and cosmetic surgery. Dr. Shorr is Director of the Fellowship in Ophthalmic Plastic Reconstructive and Cosmetic Surgery at the Jules Stein Eye Institute, UCLA School of Medicine. He and his associates are board certified ophthalmologists as well as ophthalmic plastic reconstructive and cosmetic surgeons who have completed an ASOPRS fellowship.

Dr. Norman Shorr is an early pioneer in many of the reconstructive and cosmetic eyelid, eyebrow, forehead and midface surgeries performed today worldwide. He and our surgeons continue to innovate and contribute to the specialty of cosmetic and reconstructive facial surgery. Call today to schedule your personal consultation!
Visit our cosmetic surgery and reconstructive facial plastic surgery office located in Beverly Hills, near the Los Angeles area.
 

We specialize in cosmetic and reconstructive surgery of the eyelids and face, as well as non-surgical treatments and services. Our office is conveniently located in Beverly Hills, California (CA), near Los Angeles and bordered by Orange and Ventura Counties. Call us today for an appointment or for more information!

CONTACT US / BACK TO TOP