Up to one in twenty children are born with blocked tear ducts (nasolacrimal duct) causing a constant wet eye and mucus accumulation within the eyelashes. Usually this settles in the first 18 months of life, however some children will need to have a small surgical procedure to rectify the problem.
As we age the nasolacrimal duct often starts to narrow causing tears to accumulate, when tear production outstrips drainage. This can blur vision and then tears may overflow and trickle down the face irritating the skin, smudging spectacles and causing social embarrassment.
Treatment of epiphora (watery eyes) includes the following:
Dacryocystorhinostomy ((Endoscopic or External ): Dacryocystorhinostomy is a procedure to treat watery and sticky eyes caused by narrowing or blockage of the tear drainage tubes (nasolacrimal duct). A direct connection between the tear drainage sac and the side wall of the nose is made in order to bypass the nasolacrimal duct.
- External (DCR) Dacryocystorhinostomy: The external procedure was initially described in the 1800’s and involves an incision on the side wall of the nose.
- Endoscopic (DCR) Dacryocystorhinostomy: Is a more modern technique, the procedure (usually under a general anaesthetic) is performed through the nostril, so no skin incision is required. Post-operatively there is no visible bruising.
Both procedures are routinely performed as a day surgical procedure. The operative time for both techniques is approximately 45 minutes.
Probing & Syringing +/- Intubation: This is for children with blocked tear ducts. It is performed under general anaesthesia as a day surgical procedure. During this procedure a thin flexible probe (wire) is inserted down the tear duct to clear any blockage. It is best performed under direct trans-nasal visualisation using a nasal endoscope and camera. This is the most accurate and least traumatic way to perform the surgery when stenting is required. It also allows the surgeon to best predict which patients are most likely to fail a simple probing of the duct. The surgeon may then proceed directly to placing the lacrimal stents under the same general anaesthetic.
Lacrimal Stents: Lacrimal stenting are usually performed as a day surgical procedure under anaesthesia. Lacrimal stents are thin tubes that are implanted in patients with narrowed but not completely blocked tear ducts.
Thyroid Eye Disease (TED): this is an auto-immune condition often associated with an abnormally functioning thyroid gland. It is characterised by inflammation, scarring and hypertrophy (overgrowth) of the orbital fat and muscles. Typical manifestations are, protrusion of the eyes (proptosis or exophthalmos) made more prominent by retraction of the upper and lower eyelids which can also cause severe dry eye. Muscle involvement can cause double vision.