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DCR surgery for a blocked tear duct: what to expect

Normally, tears drain from the inner corner of the eye into the tear sac beside the nose, and then down the tear duct into the nose. When the tear duct is blocked, tears have nowhere to go: they spill over the lid, the sac fills with mucus, and it can become infected again and again. DCR surgery is the usual treatment for a blocked tear duct in adults. For the other causes of a watering eye, see watering eye, blocked tear duct, styes and chalazia.

Who needs DCR surgery?

DCR is usually advised when an examination confirms a blockage in the tear duct below the tear sac, and:

• the eye waters enough to blur vision, make the skin sore or get in the way of daily life
• there is a sticky discharge most days, or mucus comes back into the eye when the inner corner is pressed
• the tear sac has been infected (dacryocystitis), especially more than once
• cataract or other eye surgery is planned, and the tear sac is blocked or infected

The last point matters. An infected tear sac holds germs right next to the eye, and it raises the risk of a serious infection inside the eye after cataract surgery. So a blocked, infected sac is usually treated first.

A watering eye caused by dry eye, allergy, a loose lower lid or narrowed openings at the lid corner is not treated by DCR. That is why the cause is confirmed before surgery is discussed.

Which tests are done before DCR?

• Syringing: after a numbing drop, salt water is gently flushed through the drainage channel with a fine, blunt tube to see whether it reaches the nose or comes back.
• An examination of the lids and the eye surface, to rule out other causes of watering.
• An examination of the nose, when needed, because nose problems can affect the operation.
• A general health check before surgery, including blood pressure and sugar. Tell us about any blood thinners or other medicines; do not stop them on your own.

How is DCR surgery planned?

DCR surgery is done at ReNew Vision. Once the tests confirm the blockage, the eye doctor explains the plan for your eye, what to expect on the day and the aftercare, and answers your questions before you decide.

What is recovery like?

• Most people go home the same day or the next day.
• A little bleeding from the nose is common for the first day or two. Sit up, keep your head raised, and press gently on the soft part of the nose if needed.
• Do not blow your nose for about a week or as advised, and sneeze with your mouth open.
• Avoid heavy lifting, bending low and hard exercise for the first week or so.
• Use the eye drops, nose spray and any other medicines exactly as prescribed.
• Keep every follow-up visit, so that the eye doctor can check the healing and explain the next steps of your aftercare.
• Some watering can continue for a few weeks while the swelling settles.

DCR can be done at any time of year, including the monsoon; the season makes little difference if the aftercare advice is followed.

Call at once, day or night, if you have heavy bleeding from the nose that does not stop with pressure, increasing pain or swelling around the eye, fever, or a drop in vision. Emergency eye care at ReNew Vision is available 24 hours; see eye emergency.

What are the risks?

DCR is a well-established operation, but like any surgery it has risks, which the surgeon explains for you:

• bleeding, usually from the nose
• infection
• the new channel closing again, which may need a further operation
• rare serious complications, and the risks of anaesthesia

Will my eye stop watering after DCR?

For most people with a confirmed blockage of the tear duct, watering and stickiness improve once healing is complete. Some watering can remain if there is another cause as well, such as dry eye, a loose lower lid or narrowed openings at the lid corner, and those may need their own treatment. The surgeon will tell you what to expect for your eye before you decide.

Can a blocked tear duct be treated without surgery?

In adults, a fully blocked tear duct rarely opens again on its own. Medicines treat an infection of the tear sac, but they do not clear the blockage, so the infection tends to return. If the watering is mild and there is no infection, some people choose to live with it, and that is a reasonable choice to discuss with the eye doctor.

Babies are different. A blocked tear duct in a baby often clears by itself by the first birthday, and DCR is rarely needed in young children. If a baby needs a procedure to open the duct, it is arranged by referral.

How do I book?

ReNew Vision Eye Hospital, 2nd floor, Pai Hospital building, Vaddem Merces Road, Vaddem, Vasco da Gama. Eye OPD Monday to Saturday, 4 pm to 7 pm. Call or WhatsApp 072489 88039. Bring a list of your medicines and any earlier eye or nose reports. Directions are on the visit page. For lumps in the eyelid, see stye or chalazion.

Questions patients ask

Is DCR surgery done at ReNew Vision?

Yes. DCR surgery for a blocked tear duct is done at ReNew Vision, after the tests confirm where the blockage is. The eye doctor explains the plan and aftercare for your eye before you decide.

How long does it take to recover from DCR surgery?

Most people return to light daily activities within a few days and to normal work in about one to two weeks. Avoid blowing your nose for about a week. Some watering can continue for a few weeks while the swelling settles.

Can a blocked tear duct be treated without surgery?

In adults, a fully blocked duct rarely clears on its own. Medicines treat an infection but not the blockage. In babies, the duct often opens by itself by the first birthday.

Why must a tear sac infection be treated before cataract surgery?

An infected tear sac holds germs next to the eye and raises the risk of a serious infection inside the eye after cataract surgery, so the sac is usually treated first.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.