Blocked tear duct procedure: Restoring comfort and clear vision with less scarring

Our eyes are not only a window to the world but also a mirror of our emotions. Tears play a crucial role in keeping our eyes lubricated and maintaining their overall health. However, a blocked tear duct can disrupt this delicate balance, leading to discomfort, excessive tearing, and even vision problems.

Thankfully, with advancements in medical technology, an otolaryngologist, or an ear, nose, and throat (ENT) specialist, can perform a simple yet effective procedure to restore proper tear drainage and alleviate the symptoms associated with a blocked tear duct though a minimally invasive approach also known as a scar less surgery.

Understanding blocked tear ducts

The tear ducts, also known as lacrimal ducts, are small tubes responsible for draining tears from the surface of the eye into the nasal cavity. When these ducts become partially or completely obstructed, tears accumulate in the eye, causing a range of issues. Blocked tear ducts can be congenital (present at birth) or acquired due to injury, infection, or age-related changes.

Symptoms

• Excessive tearing: Also known as epiphora, this is a common symptom of a blocked tear duct. Tears are unable to drain properly, resulting in their overflow onto the cheeks.
• Eye irritation: The pooling of tears can cause redness, itching, and irritation around the eye.
• Eye infections: Stagnant tears create a favorable environment for bacterial growth, leading to recurrent eye infections and inflammation.
• Crusting and discharge: Due to the presence of bacteria, the eye may develop discharge or crusting, especially upon waking up.
• Blurred vision: In severe cases, a blocked tear duct can lead to blurred vision, particularly when the tears obstruct the visual field.

When conservative management, such as warm compresses and massaging the tear duct, fails to provide relief, an ENT specialist may recommend a procedure to open or bypass the blocked tear duct. The most common procedure performed by ENTs for this purpose is called an Endoscopicdacryocystorhinostomy (DCR). This is a scar less DCR. Traditionally this is done externally with a small incision on the outside (external) of the nose. This procedure includes:

Anesthesia: The procedure is typically performed under general anesthesia.

Incision and Access: The surgeons make a small incision on the inside of the nose, working from inside out to open up the tear duct. The incision is inside the nose leaving no visible incision or scar.

Creation of a New Pathway: The ENT surgeon works with specialized ophthalmologist and they are able to completely remove the bone as well as scarred tissue blocking the tear drainage system opening up the tear sac into the nasal cavity. This restores the function is the tear system allowing tears to flow directly into the nose. At the same time, any anatomical issues inside the nose are addressed so that unwanted scaring and failure of surgery, is avoided.

Placement of a Stent: To ensure patency a stent is placed for good measure and left for several weeks to allow tears to effectively drain.

Closure and Recovery: no need for incision closure, and the nose is not packed because any anatomical issues in the nose are corrected by the scar less approach. This leads to a much more comfortable experience for the patient. Patients go home the same day and simply have to rinse their nose with a nasal rinse that we provide.

Benefits and recovery

The blocked tear duct procedure offers numerous benefits to patients suffering from this condition. By restoring proper tear drainage, it significantly reduces discomfort, excessive tearing, and the risk of recurrent eye infections. Furthermore, it can improve vision clarity, allowing individuals to resume their daily activities without hindrance.

Recovery after the procedure is relatively smooth for most patients. Mild swelling, bruising, and congestion around the nose and eye region is exceedingly rare with the scar less approach, but if they do occur, subside within a few days. Pain medication and nasal saline rinses may be prescribed to aid in comfort and healing. Most patients do not need their pain medication. The stent, is usually removed in a follow-up visit after a few weeks in the office which is painless. Full recovery typically takes several weeks, during which the patient is advised to avoid strenuous activities and to follow the surgeon's instructions diligently.

A blocked tear duct can cause considerable discomfort and affect one's quality of life. However, thanks to the expertise of ENT/Ophthalmologist team specialists and the availability of the blocked tear duct procedure, relief is within reach. By opening or bypassing the obstructed tear duct, this procedure restores proper tear drainage, allowing individuals to experience comfort, clear vision, and an improved overall eye health.

If you suspect that you have a blocked tear duct or are experiencing symptoms related to tear duct obstruction, consult with an ENT specialist to explore your options.

Alexander Farag is an expert Rhinologist who is fellowship trained in nose, skull base and orbital surgery. His specialty focuses on treatment of issues and illnesses with the nose and sinuses including revision surgery as well as some tumors of the eye and brain using minimally invasive approaches.

For more information about our ENT services and procedures, please call us at (800) 889-3627 or visit the Orange Park Hospital website.