When the tear duct (nasolacrimal duct) becomes blocked, a condition also referred to as dacryostenosis or nasolacrimal obstruction, the body’s natural ability to drain the tears into the nose becomes impacted due to narrowing or closure of the nasolacrimal passage. When the tears cannot effectively drain through the correct channels, they begin to overflow, flooding the face and cheeks or causing persistent infections.

Dr. Cox is an experienced oculofacial plastic surgeon with unique training to surgically correct any issues impairing the tear drainage system. Lacrimal (or tear duct) surgery – also known as dacryocystorhinostomy (DCR) – creates a new path for the tears to drain effectively through the nasal passageway.

How Do I Know If I Am a Candidate?

If you are noticing any of the following ocular signs of tear duct blockage, contact Dr. Cox right away:

  • Crusts on the eyelids
  • Red eyes
  • Excessive tearing
  • Uncomfortable swelling at the corners of your eyes near the nose
  • Recurring inflammation or infection
  • Abnormal discharge
  • Blurry vision
  • Infected lacrimal sac (dacryocystitis)

When any of the above signs are persistent, you may be considered a candidate for a surgical tear duct treatment. A precaution to consider for candidacy is that the treatment is less successful for patients who have sinus disease, previous nasal surgery, or trauma to the mid-facial area.

What Can I Expect from the Procedure?

Tear duct surgery is performed using a combination of local anesthesia and IV sedation. A drainage system is created as a bypass between the internal part of the nose and the nasolacrimal (tear) sac:

  • External dacryocystorhinostomy: This procedure uses a small external incision at the place on either side of the nose where the nasal pads of eyeglasses rest.

By creating a tiny space in the side of the nasal bone, the lacrimal sac is then able to effectively drain into the cavity of the nose. A comfortable silicone stent is placed in the targeted area to allow the bypass to stay open as it heals. Additionally, Dr. Cox will use dissolvable sutures that fade away on their own.

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What Is the Recovery Process?

Because tear duct surgery is considered an outpatient procedure, patients will go home to recover the same day. There may be mild swelling or tenderness that dissipates after a few days. Dr. Cox will give you a detailed post-treatment aftercare plan to optimize your healing process. The silicone stent is typically removed after about 3-6 months. You will likely receive a prescription for healing eye drops and a decongestant nasal spray to use for the first week post-surgery to reduce inflammation and prevent infection.

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Is tear duct surgery covered by insurance?

What are the risks?

Is the surgery painful?

Is tear duct surgery covered by insurance?

Tear duct surgery is considered a functional procedure, and medical insurance companies typically cover some or all of these types of surgeries. The best way to find out exactly what your plan covers is to contact your health insurance provider directly.

What are the risks?

Tear duct surgery is a successful treatment for excessive tearing in over 90% of patients. Some risks are the closure of the bypass fistula, nasal bleeding, decreased blinking, infection, vision issues, and leakage of the cerebrospinal fluid. Although rare, most of these potential complications slowly improve in the following weeks and months.

Is the surgery painful?

A mild to moderate amount of pain is considered normal during the first couple days of recovery post-surgery. Typically, acetaminophen will effectively control the discomfort. Steer clear of nonsteroidal anti-inflammatory medications, though, because they are known to cause bleeding during the vulnerable recovery period.

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