Ask An Expert: Tear Duct Obstruction

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Ask An Expert: Tear Duct Obstruction

Question:

I have been diagnosed with tear duct obstruction and have been told I need a procedure called dacryocystorhinostomy. Is there any other way to treat this condition rather than having this surgery?

Answer:

Specialists in the field of orbital plastic surgery almost always do this type of surgery. The objective is to create a new channel for the tears, so they flow easily from the tear lake of the eye into the nose.

Today the procedure can be much less invasive than it was years ago.

The approach to making a new channel for the tears can involve an incision in the skin at the point where the lower lid meets the nose, or the entire operation can be done through the nose with laser. The laser is simpler for the patient. However, some surgeons think better results come from the skin incision. The choice of technique depends on the likely location of the obstruction and the preference of the surgeon.

After the surgery, the patient may have a plastic tube temporarily left in place to make sure the new channel stays open. Sometimes, a tube is inserted knowing that it may remain in place permanently to keep the drain open.

Usually patients who reach the point of needing this surgery have a significant problem with tearing.

I advise approaching this in a simple way. It is an all-or-nothing situation. There is no intermediate step that has any value. If you are in the situation of constantly dabbing at your eye with a tissue or a handkerchief, then surgery is the only therapeutic option.

Don Bienfang, M.D, is an assistant professor of ophthalmology at Harvard Medical School and the Senior Surgeon in the Department of Surgery and Chief of Neuro-Ophthalmology in the Department of Neurology at Brigham and Women's Hospital.

Last updated:	May 10, 2007