Tearing Problems (Lacrimal Disorders)
Children: congenital nasolacrimal duct obstruction, more commonly known as a tear duct obstruction, is a common condition that affects more than five percent of all infants and is present at birth in these children. Tears usually drain through small openings in the corners of the eyelids, known as puncta, and enter the nose through the nasolacrimal duct. When an obstruction exists, tears cannot properly drain from the eyes and may well up on the surface of the eye and overflow on the eyelashes and eyelids. The eyelids may also become red and swollen with yellow or green discharge. While most nasolacrimal duct obstructions clear on their own during the first year of life, certain measures can be taken to ensure that the eye is kept clean and free of infection, such as a tear duct massage performed three times a day or antibiotic eye drops to relieve discharge. If an obstruction does not clear up by the time the child is one year old, minor surgery may be recommended to relieve the obstruction. This procedure involves passing a soft probe through the tear duct and into the nose to open any obstruction within the path. The procedure takes about 10 minutes to perform.
Adults: it is also not uncommon to for adults to complain of tearing problems. Tear duct obstruction may arise at any age within a person’s life and may be due to underlying infection, inflammation, or narrowing of the tear duct. Patients may complain of excessive tearing or discharge from the inner corner of the eye. Correction of this condition usually requires a surgery called DCR (dacryocystorhinostomy). DCR surgery is performed on an outpatient basis and often takes less than 45 minutes under general anesthesia or sedation. In DCR surgery, a new tear passage is created, effectively bypassing the area of blockage in your tear duct. It may be performed either externally through a cosmetic skin wound, or through the nose (endoscopic). A tiny stent may be placed in the new tear drain and kept there for several months after the procedure to ensure the duct will remain open.
In rare cases in which the tear drain blockage cannot be cleared due to blockage higher up in the tear drainage system, a small but permanent tube known as a Jones tube may need to be inserted in the area. This offers a permanent solution to keeping the tear duct clear.
After surgery, there is a standard recovery time of one week, however many people are able to return to work after just 2-3 days. Most patients require an antibiotic ointment or drops to prevent infection. Activity and exercise, as well as nose blowing, are to be limited during the first week. You may experience mild bruising or swelling in the eye region, which typically resolves within one to two weeks.
DCR has a very high success rate and is considered a safe, low-risk procedure. However, all surgical procedures do carry some risk of complications. Those associated with a DCR are typically bleeding, infection and problems stemming from use of anesthesia. These are quite rare, though, and you can keep your risk factors as low as possible by choosing a skilled, experienced physician and following all pre- and post-surgical instructions.