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A dacryocystorhinostomy (DCR) is an operation on the tear drainage pathway to help improve drainage of tears from the eye to the nose. It is usually performed when there is a blockage in the main tear duct between the eye and the nose (the nasolacrimal duct), that has caused the eye to water and sometimes become infected.

It is also sometimes performed when there is a partial blockage to improve tear drainage.

The eyeball is kept moist and healthy by a thin film of tears that is continuously produced by the lacrimal gland situated underneath the top eyelid. Every time you blink, tears are swept towards the inside corner of the and drained through two tiny tubes called lacrimal canaliculi. From there, tears pass into the nasolacrimal sac, then into the nasolacrimal duct to the nose and, ultimately, to the throat for swallowing.

A blockage along any point of this tear duct system is known as a blocked tear duct or dacryostenosis.

The symptoms include a pus-like discharge

Some babies are born with a blockage (congenital dacryostenosis). A range of conditions and events can cause acquired dacryostenosis. In adults, most cases are due to thickening of the lining of the duct leading eventually to blockage.

The symptoms of a blocked tear duct can include:

  • increased susceptibility to eye infections. Some of the causes of a blocked tear duct include
  • some babies are born with a blockage within the tear duct system
  • usually the nasolacrimal duct. The thin membrane that seals the nasolacrimal duct in utero fails to open at birth or soon after – in most adult cases
  • the lining of the tear duct becomes thicker with age
  • eventually leading to blockage – infection
  • inflammation of the conjunctiva (the thin membrane covering the eye)

In rare cases, the tear duct system may become infected and blocked, especially after some viral infections. A blocked tear duct is diagnosed using a number of tests, including: particular tests to check for tear drainage – for example, a special fluid is flushed into the affected tear duct opening. A diagnosis of blocked tear duct is made if the patient can’t taste the fluid in their throat – taken of the tear duct area (dacryocystogram).

Dacryocystorhinostomy explained Blocked tear duct’s eye Symptoms of a blocked tear duct watering eye tears running down the face discharge of pus crusted mucus along the eyelashes Causes of a blocked tear duct congenital conditions chronic nose infections – chronic sinusitis may irritate the tissues and form scars, which may block the tear duct system nose trauma – such as a broken nose.

The injured tear duct system may be blocked by scar tissue inflammation of the lining of the tear duct conjunctivitis Diagnosis of a blocked tear duct physical examination – including medical history ophthalmic examination – to check for other possible causes x-ray or CT scan Where to get help Your GP (doctor) NURSE-ON-CALL (616) 555-0024 – for expert health information and advice (24 hours, 7 days) Eye specialist The Royal Michigann Eye and Ear Hospital (616) 555-0200.

Key Points

  • symptoms include a pus-like discharge
  • range of conditions and events can cause acquired dacryostenosis
  • symptoms of a blocked tear duct can include: increased susceptibility to eye infections