Watery Eyes & Blocked Tear Ducts – Treatments & Surgery Guide

Watery eyes (also called epiphora) are a common condition where tears overflow from the eyes due to poor drainage. This can be caused by blocked tear ducts, narrowed tear openings (puncta), or inflammatory eyelid conditions like blepharitis. If untreated, it may lead to discomfort, blurred vision, and recurrent infections or eyelid cysts. Your eye specialist will first assess your tear drainage system before recommending treatment.

✅ Common Treatments for Watery Eyes

1. Lacrimal Syringing (Tear Duct Flushing)
   • A quick, painless clinic test to check if your tear ducts are open.
   • A small amount of sterile saline is flushed through the tear duct system.
   • Helps diagnose blockages and guides further treatment for watering and recurrent infections.
2. Punctoplasty (Opening the Tear Ducts)
   • A minor surgical procedure to widen the puncta (tear duct openings).
   • May be done with or without a temporary silicone stent.
   • The stent is not visible or painful but helps maintain the opening during healing.
   • Watering usually improves only after the stent is removed (after a few weeks).

What is Dacryocystorhinostomy (DCR)?

DCR surgery is offered when the main tear duct (nasolacrimal duct) is permanently blocked. It creates a new pathway from the tear sac to the inside of the nose, allowing tears to drain properly again.

There are Two Types of DCR:

🩺 1. External DCR

• Performed through a small 10–15mm incision on the side of the nose.
• A soft silicone tube is inserted to keep the new passage open.
• Stitches are removed in 7–14 days.
• Leaves a small, often barely visible scar.

🩺 2. Endoscopic (Scarless) DCR

• Minimally invasive – no external cut or visible scar.
• Surgery is performed inside the nose using a fine camera (endoscope).
• A silicone tube is inserted as with external DCR and removed after 4–6 weeks.

✅ Joint Care with ENT Surgeon

• At St Anthony’s Hospital, Sutton, Endoscopic DCR is performed in collaboration with an experienced ENT (Ear, Nose & Throat) surgeon.
• This combined approach ensures safe and precise access, especially if nasal or sinus issues contribute to your blocked tear duct.
• 📝 Please contact me in advance if you're considering this procedure — I’d be happy to discuss your suitability and answer any questions.

🩺 Before Surgery – What to Expect

• Examination of your eyes and nose.
• Lacrimal syringing and possibly a nasal endoscopy (small camera inside the nose).
• Pre-operative assessment including:
  • Blood tests, ECG (if needed).
  • Advice on stopping medications like blood thinners (aspirin, clopidogrel, warfarin).
  • Fasting instructions if under general anaesthetic.

After DCR Surgery – Recovery at Home

• A soft silicone tube remains in place for 4–12 weeks.
• Avoid blowing your nose forcefully.
• Use eye drops and ointment to prevent infection.
• A follow-up appointment will be arranged before discharge.

👨‍⚕️ General Post-Op Care:

• Rest for 24 hours.
• Avoid exercise, alcohol, swimming, and driving for 1–2 weeks.
• Use Sterimar nasal spray to gently cleanse the nose after 1 week.
• Mild bleeding and watery eyes are common initially.

🚨 When to Seek Medical Help

• Bleeding that lasts more than 30 minutes.
• Severe or increasing pain.
• Redness, swelling, blurred vision, or pus.
• Tube becomes loose or displaced.

✅ Success Rate of DCR Surgery

• Around 80% of patients see long-term improvement in watering.
• Reduces risk of infections, irritation, and recurring cysts.
• Most patients find lasting relief after full recovery.

📅 Follow-Up Care

• Follow-up visit scheduled within a few days after surgery.
• Silicone tubes are removed between 4–12 weeks after healing.
• Additional appointments arranged if needed based on symptoms and progress.