Tear Drainage Surgery

Dacryocystorhinostomy

A dacryocystorhinostomy is an operation to alleviate a watery eye. A watery eye is often caused by a blockage of the tear duct which connects the surface of the eye to the nose. The blockage may be at any point from the small holes on the lids (the puncta) to the bottom ends of the main tear duct (the lacrimal duct) Your doctor will have examined you to rule out other causes of a watery eye such as inflammation of the eye or lids and will have determined the likely site of the blockage. If you have a partial blockage, it can be difficult to tell exactly where the block is. If the block is felt to be at one of the holes on the eyelids, a very small day-case operation under local anaesthetic can be performed to enlarge the holes. If the block is felt to be further down the system, a dacryocystorhinostomy is the treatment of choice.

The Human Tear Drainage System

Complications

Side effects that may occur later include infection of the wound or operation site, but this is rare. A secondary nosebleed may occur at about a week, but taking the antibiotics post operatively will reduce this likelihood. Occasionally the tubes can work their way out at the top end, but can be easily replaced in the eye department using a few drops of local anaesthetic. Unless excessive scarring takes place, the scar from the wound does not usually cause a cosmetic problem and is often very difficult to see.

Post operative instructions:

Tear drainage surgery

After your surgery you will have a small dressing covered by tape over the wound on the side of your nose. Remove the dressing the morning after your surgery. There may be some localized bruising and swelling which is quite normal. Your eye may be slightly red. Take life easily for the first few days.

If there is any discharge around the wound, clean it away using cotton wool and boiled water. Try not to clean the wound itself. You will see that there is a stitch in the wound, this will be removed a week after your surgery.

You may have some blood spots from the nose; this should settle a day or so after surgery. If you get a nosebleed, which does not settle, you should be seen in the clinic immediately. The nose may feel congested to start with, this will settle in the first few weeks.

Use the eye drops as instructed, and if you have been given antibiotic tablets, finish the five day course.

Your eye may still be watery in the first weeks after your operation. This is because the silicone may be blocking tear outflow. The silicone prevents scarring during postoperative healing. When this is removed it will be clear whether the surgery has improved your watering.

• Don't blow your nose for three weeks. When the silicone has been removed, you may feel a tickling sensation at the inner corner of the eye when you blow your nose. This is quite normal and is caused by air being blown backwards through the tear system. It is actually a good sign and shows that the tubes are clear.
• Don't swim for three weeks.
• Don't strain or lift heavy objects for two weeks.

You will be seen at one week for suture removal and between two to four months for silicone tube removal. Tube removal takes place in the clinic, requires no anaesthetic and is painless. If your nose feels congested after the surgery, tube removal usually improves this.

If you have any undue pain or worsening swelling or any other concerns, please do not hesitate to contact me through my secretary.