Oct 112012
This is a fairly complete list of the risks and complications associated with DCR surgery for block tear ducts. Some of these are specific to external DCR and others are specific to the endoscopic variety, but in general they all apply to both varieties. If you aren’t willing to accept that these complications could occur, then you probably should not have the procedure done. While some of these complications are rare, they are all very possible and well-documented.
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Intraoperative Complications
- Excessive uncontrollable bleeding may require abandoning the operation and reattempting it at a later date.
- Damage to the medial rectus and superior oblique may cause diplopia.
- Blindness may occur from damage to the intraorbital vessels or optic nerve.
- Cerebrospinal fluid leak due to penetration of the cribriform plate
- Injury to the orbital contents from rongeurs or drill
- Injury to the canaliculi from improper probing
- Shredding of the lateral nasal mucosa due to improper bone removal
Postoperative Complications
- Sump syndrome may occur if the rhinostoma is small and high up in the lacrimal sac. This causes tears and mucus to accumulate in the sac and discharge into the eye.
- Ocular-orbital lesions, especially from orbital fat exposure
- Persistent watering may indicate scarring of the rhinostoma and may require reoperation.
- Orbital hematoma (eye swelling with blood)
- Subcutaneous emphysema
- Canalicular laceration
- Cerebrospinal fluid leakage (leading to greater risk of infection, such as meningitis)
- Air regurgitation through puncta, especially when sneezing and when talking
- Disturbing altered sensation in eye
- Dry eye
- Persistent pain at surgical site, even after healing
- Infection
- Swelling and bruising
- Excessive tearing
- Facial scarring (in external DCR)
- Sinusitis
- Complete failure/additional surgeries
Complications associated with silicon intubation as part of DCR
- Pyogenic granulomata may occur at the puncta or the site of rhinostomy if the tubing is left in too long.
- Retrograde migration and corneal irritation
- Soft tissue infection
- Retained silicon tube and DCR failure
- Adhesions, elongation, slitting or erosion of the puncta
- Nasal migration
- Traumatic injury to the nasal septum
I recently had tents put in both eye I am experiencing numbness in my lip teeth and nose in the right front quadrant I hope this goes away as it was not mentioned anywhere as a post op symptom can anyone tell me if this is normal ?
I assume you had a DCR recently Thomas? There is a lot of information they do not tell you about post-operative complications. All you get told is bruising, bleeding and infection. In truth, there are a LOT more potential complications. I suspect if they tell their patients, they’ll lose money due to patients refusal to have the surgery.
I am supposed to go to have my eye opereted on for astopped tear duct did yours ever clear up completly
After 12 months of steroid drops I kept tearing occasionally. About twice every few minutes. So it never really cleared up. Who told you, that you’re “supposed” to have it operated on? According to whom? It’s your choice, your body. Having gone through DCR I’d advise you to seek an alternative non-invasive method and demand a macryodacrocystogram to determine specifically where the block is located. A simple probing may help? If the tearing returns try balloon dilatation?
Ditto. Has yours resolved? Mine is four months post surgery on one side. I call it nerve damage.
I had a DCR dome on my left eye. Immediately post up i developed ptosis. Is this a complication of DCR surgery.
Any surgery around the eye has the potential to cause ptosis. In particular DCR since I’ve seen so many pictures and read forums of DCR victims developing mild or severe ptosis. Drilling through bone and manipulating the tear sac is bound to mess with nerves innervating the eyelid.
Your ptosis might go away. I have a very slight ptosis from DCR that’s permanent and thus I insist on eye doctors to STOP using DCR and the ‘gold standard’ for epiphora. It’s NOT the “gold standard” if it imposes more risks than non-surgical techniques that may not be quite as high in success rate (below 90%) but certainly patients would prefer less risk.
Thanks you George for the information.
Hi I recently had a dcr to the right eye.. With tubing . I am aware the tubing is to that in situ for several weeks .. Things I’m unsure about are …
Does sneezing and breathing affect the tube positioning , and is it possible for the tube to be somewhere other than the nasal passage as I can no longer feel it up my nose , but can feel the sensation that’s there is a foreign body in there ..
I really am just wondering if I need it to be pulled back down , or if it will serve it’s purpose wherever it has come to rest ..
They loop of the tube is clearly visible from the tear ducts , and it’s the ends that concern me
Hi Tracey, whilst I’ve heard about the bicanicular tubing having to be replaced, it’s very uncommon. I never felt the tubing in my nasal region and only felt the rubbing of the tubing that’s visibly noticeable on my eyeball. I couldn’t wait to have it removed. If you are concerned, see your surgeon again for your own peace of mind. However, I believe the tubing is where it should be, and that is through the osteum to make sure it’s patent and does not scar over.
Had surgery on both eyes. Internal dcr left eye tube came out 2 Days after surgery Dr. Not the one that did the surgery, There were 3 Drs that work on different days. He Pushed it back in, got home it was back out, next day back to Dr. He removed it through my nose. One week later from day of Surgery. Right eye which had dcr external with bone removal the tube moved to middle of my eye. Back to the Dr. That did the surgery. She removed the tube thought my tear duct because she could not find it in my nose. That Hurt. Now slight bleeding from my nose and tear duct. Going to call Dr. That did Surgery tomorrow to see what’s going on.
All the misplaced tubing sounds like a nightmare. I’ve had many complaints about the exact same thing. I’m not certain why the surgery seems to go without an issue for a proportion of people, yet others experience a wide range of complications.
All the best with your next doctor’s appointment and please keep us updated with your progress.
Hi my mother had a DCR done about a week ago last night she had a runny nose and as she she was cleaning her nostril she felt something not knowing it was the end of the tube she pulled on it I am concerned that she might have displaced the tube or that it is no longer in place is there any chance that the surgery was not successful.
Hi Lana, If you can still see the ‘tubing’ in the corner of your mother eye, it’s still there and working well. You’d have to pull the entire tubing out for any problems to occur. Indeed, I had to have mine removed by my oculoplastic surgeon. He pulled it out through the nose (thus why you are probably worried) and it didn’t take much to achieve. Perhaps your mother just nudged it a bit, no harm done.
Hi Lana,
After DCR surgery, tube is placed to prevent possible scarring in the alternative passage for tear to nose that surgeon make. Typically, tube is visible at medial side of eye, but sometimes if tube is left longer in length it may appear on nostril. However this tube appeared on the nostril should not be pulled out as it can alter the passage made during surgery which leads to reappearance of tearing. But good news is that i often see many patients with self tube removal unknowingly by pulling or spontaneous extrusion through nose and they still have good results so i advise you to consult your surgeon withour worry.
I had my DCR 3 years ago. My eye has never drained properly. My headaches have come back with a vengeance and the tearing is worse. I went to the emergency room today and i was told that there is a bad infection in the tissue around the surgery site. They also informed me that the tube was never removed. I can still feel it when i clean my nose. It is now attached! How on earth will they get it out?
Hi Trinette, Your example is one of many where DCR has caused further problems. I’m sure they can remove the tubing left in your nose (even though it’s attached to skin). Perhaps the infection is because of bacteria accumulating around the tube since it’s a foreign body. Let’s hope it clears up after the residue of tubing is removed.
Another warning to everyone. DO NOT JUMP BLINDLY INTO DCR SURGERY.
Thanks for the reply. My main concern is that he told me that it’s an infection present. This morning my eye was swollen shut. I asked him for an antibiotic for the infection because I wasn’t going into surgery with an existing infection. He told me that I don’t need any because once he takes the tube out, I will be fine. That doesn’t sound right and I’m not a doctor. I was looking to change doctors but, no other doctor will correct his mistake.
I had DCR surgery one month ago and went for a checkup one day ago. He said everything was healing nicely. Howerver, after blowing my nose this evening I noticed that along with mucus etc. the silicone tubing had come right out and was in my kleenex and no longer in my eye. It seemed to have broken. How serious is this?
The silicone tubing is left in the eye at different lengths of time depending on the surgeons own decision. It could be 4 weeks or more. I believe mine was left in for 4 weeks. So if it’s been one month for you and it’s been sneezed out, it’s still done it’s job! (to keep the osteum patent). However, the situation will require another visit to your surgeon for further advice. He may replace it, or tell you it’s not necessary and it’s been in long enough. Not a real major problem.
Hi my daughter is 11 years old she was advised to go through probing procedure when she was few months old we as parents got scared and decided for her not go through it as apparently there was no symptom of blocked duct but now at the age if 11 her eye started tearing a lot and few weeks before we found out that she has blocked duct after consulting three doctors we have come to a the decision that she should go through dcr but after reading all those complication I am scared now is there any other way that the surgery can be avoided i don’t want my child to go through all this after or during the operation
It never ceases to amaze me how quick they are at recommending DCR. Blocked tear duct, get DCR. It’s the old cookie cutter style of robotic treatment, one treatment for every condition. They fail to take our emotions and concerns into consideration, and, treat us mechanically.
I don’t agree to the aggressive DCR being performed on an 11yr old. Please insist on simple probing and if that fails, balloon dilatation. Good luck!
I had a dcr done about a two weeks ago. Everything was fine until my nose started bleeding randomly. Its been two days and I’ve been experiencing frequent nosebleeds. Is this some side effect of the surgery or something else unrelated?
This really is a medical emergency, you need to have this attended too as soon as possible. A nose bleed immediately after surgery is normal but not two days afterwards. DCR carries many risks and they are all marginalized by the surgeons who performs them, certainly bleeding after two days is alarming. Please let us know if you’re okay now.
it’s been 5 months since my DCR got up this morning in August and I am bleeding from the area where the tube was placed. Although when the Dr. took the tube out he told me that he broke a part of tubing off, and that “quote” it should come out through my nose.
Hi Doris, you definitely need to return to your surgeon and discover the cause of the bleeding. Only a small amount of bleeding could imply a very serious problem. It’s difficult to ascertain whether it was caused from any remaining tubing? However, since DCR involves drilling through bone, one complication is cerebro-spinal fluid leakage. So always take bleeding at the DCR site seriously.
Please write back and let us know how you go.
Long story, wish you could call me 415/299-7438. Summary: I had dry eye, had 4 ducts cauterized many times, dry eye eventually improved, had tubes put in to open them, told them to remove too soon. Now, upper ducts open. Lower ducts are open, But FLUSH flat closed (since I told them to remove tubes too soon I’m guessing they didn’t round out) 20 years later and all around mouth, beginning from tear duct area, I feel paralyzed. Guessing no lubrication in those ducts, made them swell up the area. Doc was going to do a ‘one snip,’ then for an odd reason decided against it. Please help!
Hi Havad,
Thank-you so much for sharing your story here, you are amongst friends who understand how you feel and share your pain. Explanations on conditions and procedures can be confusing here due to different nationalities and lack of medical and anatomical understanding. So I need to ask you a few questions and have you clarify further.
So you had dry eyes? How old are you? and when did the dry eyes begin? Do you know what caused them? How severe? Did you have all four punctum’s cauterized at once without trying plugs first? Most people have the lowers cauterized and if no relief have plugs placed in the uppers. Usually that helps, sometimes it doesn’t. However, the upper plugs can always be removed if epiphora is a problem. So having all four ducts cauterized at once is risky. Furthermore, why did you have the ducts cauterized ‘many’ times? Did they keep re-opening? If they did, then it’s usually the technique used, did they cauterize deep enough then use a suture to hold it tight? It seems the ducts were eventually closed properly if you’re dry eyes had improved.
Now here is where I am very confused, you state, “had tubes put in to open them, told them to remove too soon”. Where did you have tubes placed? Why did you need tubes placed? Surely not through the cauterized ducts, unless we are not speaking about “punctal ducts”?? We may not be, because you wouldn’t want tubes put through your cauterized punctal ducts if they were helping. Or are you referring to the ‘naso-lacrimal ducts’?
You told them to remove the tubes too soon, now the upper ducts are open? I am not understanding you, can you please clarify? Are you referring to DCR surgery? and mean a ‘bi-canicular’ tubing and had that removed too soon? Well if you are referring to a bi-canicular tubing it would be difficult to get that through cauterized punctum’s.
So you’ve gone from four cauterized ducts to four open ducts? What ducts are you referring too again? And why are they now open?
Your statement: “But FLUSH flat closed (since I told them to remove tubes too soon” – it surely seems like you’ve had a DCR here and the FLUSH is the saline going in through the punctal opening (usually the upper). So the saline regurgitated and didn’t flush down to your throat? Am I correct? And you believe it’s due to taking the bi-canicular tubing out too early? How early is too early? How long was the bi-canicular tubing in there for? Anything from 4-6 weeks is usually sufficient.
This all occurred 20 years ago? Just wondering why have a DCR (if that is the procedure you had) if you had ‘dry’ eyes and cautery provided some relief? DCR is only for watery eyes. Did the cautery cause watery eyes since you had all 4 ducts cauterized? If so, you certainly didn’t need DCR surgery, they can reverse cautery providing they have totally ablated the canaliculus. Please let us know if the cautery caused you epiphora.
The paralyzed feeling beginning from tear duct area to your mouth could be several different conditions. Look up the symptoms in a “Differential diagnosis” book and you’ll find many different possible causes. You guess it’s the lack of lubrication causing the paralysis sensation? The lack of lubrication in the ducts may or may not be causing the problem. I do know a dry eye sufferer with pins and needle sensations around her face and cheeks. Her doctor is dismissing the problem.
So the doctor wanted to perform a ‘one’ snip procedure to open your punctum’s more? But didn’t you need them cauterized? Are you now producing more tears compared to 20 years ago? Did you ask the doctor why he decided against it?
Apart from the paralysis sensation, what other problems do you have with your eyes?
As you can see, I’ve asked many questions to fill the gaps in your explanation. Please answer all my questions and provide a more specific account of your problem so we can better advise you.
Trying to summarize left little clarity I see: So, I had RK surgery, age 19, to correct vision, soon after, I had a chemical accident to my eye, which I barely washed out. Resulted in severe dry eyes, eye drops every few mins sometimes. After several eye docs, and desperation, I decided to cauterize them myself, yes myself (with a burnt meat skewer). They’d pop open, I’d recauterize them, until, they finally stopped opening. About 18 years into the dry eye, the eyes finally improved, not really dry anymore. Doc opened by placing what seemed like fish wire through those holes (and tied together by the puncta), with intent to leave them there for so many months. I don’t know if it was DCR. He said he went through a natural opening in the nose hole…never any mention of drilling, snips, or anything. I believe that’s what happened. I insisted that he remove them perhaps 3 months earlier than he would have liked to. HUGE mistake. This left the upper ones open, the lower ones open, BUT, nothing drains through the lower ones because they’re flush in their opening (not rounded) if you can imagine this, like a closed book, where nothing will flow through. I tried having puncta plus put in, thinking they’d round out/dilate the area (then be removed) Well, docs were reluctant and had difficulty getting them in, and sounds like a bad idea after reading your site (as they can lodge themselves?). The docs also feel my puncta have migrated. After my doc used a syringe to go in and anesthetize for the ‘one-snip’ he decided their movement would somehow make the one snip a bad decision, that they’d be too big of an opening, and too much tears would drain. Only this last year (26 years ago since this happened, and about 21 years since I started closing the ducts, my mouth area has started to feel numb, slightly inflamed. I say paralyzed (but I meant numb, please excuse my emotional writing). I hypothesize that the unlubricated ducts have taken their toll. I could be wrong. I’m fortunate in the life I have these last few years where I don’t need to work, and my life otherwise is fairly at ease. I’m okay really. Thanks for your time, care, diligence. Blessings
I wonder if LASIK surgery also contributed to the dry eyes along with the chemical burn? It’s certainly caused dry eyes for thousands of people as seen on the popular forum site http://www.dryeyezone.com
WOW havad YOU CAUTERIZED YOUR OWN PUNCTAL DUCTS, you had a lot of guts back then. No-one I’ve known would be brave enough to do that. We are speaking about our precious eyes here. Thank goodness you didn’t do any damage and it took four attempts perhaps from your lack of skill. On the other hand, what you did may not have been much different to an ophthalmologist, after all, they use the same technique, simply a heated rod. Again, they also have many clients whose cauterized ducts open again. Very brave indeed! But what is perplexing here is, did it help? You said you didn’t have any relief till after 18 yrs. Ben can you recall or pin point any event that improved your dry eyes?
At this point, before I continue analysing your situation, I want to know why you had to have wires placed into your nostrils. Doesn’t sounds like a DCR to me, perhaps a ‘stent’? Were you suddenly getting ‘teary’ eye and they thought you might have a blocked Naso-lacrimal duct? – please look for images on google for ‘Naso-lacrimal duct’ so you’ll know what I’m referring too.
havad, I am eager to hear your response.
Yes, the vision correction surgery + the chemical accident days later did make for the dry eye. Yes, cauterizing them helped keep tears in my eye, gave some relief. I feel the dry eyes finally healed for a number of reasons 1) less stress, as I started working part time 2) exercise 3) better eating habits (though I still eat ‘healthy sugar’ sweets every day) 4) Important – improved attitude. I was rather negative/unhealthy relationships. I’d say the dryness is 95% gone, not really a problem. Now, my cauterized ducts to deal with. The doc put some wires through them, he said he went through a natural opening by my nose? and tied at the puncta. When he removed (too soon, my fault) the bottom holes were opened (but not rounded, so still no draining). New docs I’ve seen say the hole has ‘migrated,’ guessing the silicon tubes (or wires) pushed ’em over, over time?, and my cauterizing didn’t help either. For some reason, because of this migrating, the oculoplast decided against the ‘one-snip’ to open this hole (or to me, round it out). He says my hole is already very large (but docs determined not allowing drainage once they really test them). I was determined to try and get this one-snip, til I read your experience. Too, I’m now questioning what was done, if it wasn’t DCR. Again, I’ve started feeling numb around my mouth/cheek area and not sure what to attribute it to. Thanks again, Havad
Hello I hope you can help me REGARDING COMPLICATION FOLLOWING DACRYOCYSTORHINOSTOMY surgery.
I am a 67 year old lady ten years ago I had plugs put in both eyes for dry eye. The procedure took ten minutes in the specialists room.
Recently I had a discharge from the left eye My dry eye condition had healed years ago.
y was informed by the hospital eye clinic that the plug had probably gone side ways and blocking the area.
On two seperate occasions over a period of months I had a wire put down the side of my eyes (both) in an attempt to push the plugs through the back of my nose and down my throat flushing the area with water.
There was a clear passage through my right eye but each time the left appeared blocked.
This lead to an appointment with the specialist some months later.
I was informed by the specialist Mr Sloan, that I need to have an incision at the side of my eye to remove the plug which was obvously stuck. I was informed by him that the sometimes open like umbrellas and there for trying to pull them out can cause more damage.
We discussed my allergy to vicryl sutures. He said he would look into this. There was a
Dr from Canada present.
I asked him if I could have an MRI to confirm that the plug was there. He replied that it would not show on the MRI. I asked if a swab could be taken of the discharge, which was not as bad .as when it first presented. he said no, it was clear what the problem was
I left on the understanding I would have an operation to remove the plug.
There was NO discussion or information given re any complications that could occur.
I was not informed or consulted about another item to be plug put in are you? placed into my eye.
If I had I would not have agreed .
The day of the surgery, I had the drip with local anesthetic in my arm and I said to Mr Sloan, I dont want another plug put in.
This had been raised
By then I was 0 minutes prior to my going into surgery by a famly member who said “You arent having another plug put in are you” I had no intention of this and said to Mr Sloan I didnt want another plug in, he said, the operation wont be as successful and they are different now”. As I was in no state for discussion, drowsy, with the drip and meds going in I just said to Mr Sloan “I will have to trust you”
The result is I have had surgery almost 3 weeks ago.
I was given an appointment to see Mr Sloan two weeks after the procedur
I was just pulling into the hospital car .park and got a phone call from the hospital saying “Dont come, we have to change your appointment.
I said I had driven from Whangaparoa almost 1 hour drive away and needed to see Mr Sloan as I had a problem of ongoing excessive watering of my eye.
I went into the hospital and said I would call Health and Disability support if I saw no one for my eye.
After sometime a Dr was called who saw the eye continuosly watering, she said I had to see Mr Sloan
I have had to leave several messages at the hospital asking for an appointment, finally asking the customer service team to email the booking scheduler, who then rang and gave me an appointment for Tuesday 12 June.
Would you please help me regarding my way forward my eye is watering ongoing now.
Hi Lois, well there’s a lot going on there. It seems like the procedure caused a tearing eye. I would demand a macrodacrocystogram to locate where the blockage is. I’d also suggest you get a different opinion and follow up with someone else. Did Mr. Sloan tell you he removed the plug?
Regardless, you need to see him again and might have done that by now? Please do let us know what his comments were.
In addition: I feel over time, my eyes healed somehow on their own, as if they ‘adjusted’ or ‘toughened’ somehow.
Indeed, time is a great healer on all levels both mentally and physically. You are lucky you’re eyes have healed to an extent that you were able to resume normality in your life. Many sufferers of dry eyes only improve with a hectic schedule of various treatments. Now, we just have to deal with the current problem you have and let’s hope it will resolve with the correct treatment.
Hi Havad,
I agree that reducing stress in your life will have assisted with the dry eye symptoms. Chronic stress activates the sympathetic nervous system which, in a way, turns off the nervous innervation to the lacrimal gland that produces tears. Of course, for many serious dry eye sufferers reducing stress only helps to a certain degree.
I understand your situation a lot better now. Thanks for clarifying and persisting with explaining it to us all. So they were attempting to unblock the cauterized punctum’s and went in through the nose. Sounds like the wrong thing to do for the problem you had. Firstly, it depends on how deeply you cauterized (scarred) your canaliculus! If the cauterization was left for too long, or pressed in too far it could have totally ablated the tear drainage system and reversal is almost impossible unless they replace it artificially with a Jones tube (a replacement for your canaliculus and is permanently worn).
There is a new tool available to oculoplastic surgeons to reverse cauterized punctums/canaliculus. It’s a fine drill, and works like a apple corer, by drilling through scarred tissue forming a lumen. It basically opens your tear ducts again. However, it depends on how far down they’ve been scarred. The instrument can only be used for more superficial cautery. I informed my oculoplastic surgeon I may want my cauterized ducts reversed at some point, thus he only cauterized them to a level where he knew he could easily reverse it. I had the procedure done a few weeks ago and indeed, it’s helped my dry eyes so far.
So Havad, I can only assume your ducts were too deeply scarred to simply go in through the ducts and push them open from the corners of your eyes. You could have ablated them (scarred them) so deep to the level of the tear sac. If you did, then going in through the nostrils would make sense.
Please don’t blame yourself for having the wires (silicon tubing) removed too early. You were not to know what the result would be and you can always have it performed again. I’m also concerned if you have them opened again if your dry eyes will return.
I would obtain another two or three opinions regarding the one snip procedure and whether it would help with the migrated opening of the duct. You won’t end up with the same complications as myself because I have a hole drilled through the bone in the nasal cavity and it’s larger than the natural opening (naso-lacrimal duct) thus it drains too many tears at a rapid rate. Whilst the puncta is larger via the 3 snip procedure, if it was draining naturally into the naso-lacrimal duct I wouldn’t have had such severe dry eye symptoms. You are lucky not to have the same problem, so a one snip procedure should be totally safe and free of side effects. Although, I cannot completely guarantee that.
Regarding the sensation you are feeling around the nasal area, etc, if you saw a neurologist or eye doctor they will most likely tell you, “Not to worry, these sensations are normal and come and go”. It’s a likely response and it’s seen as a trivial thing. But it’s not a pleasant feeling for us is it? And isn’t pain/numbness a sign that something is wrong with the body? Sometimes we have to be our own doctors and it’s great we can obtain as many opinions from different doctors as we can afford to do. I’m glad I waited and persisted, I eventually contacted the best ophthalmologist and oculoplastic surgeon in my country to assist with my eyes. They are innovative and will do anything to help.
Havad, please let us know what you will do next and how your symptoms are going. We all wish you the very best 🙂
Again, such thoughtful considerations and care! More than any doc I’ve seen. You will somehow/some way be greatly rewarded for this I imagine! Keen observation, the stress from dry eye certainly exacerbates them. The eyes, our body, learn to adjust, cope, can somehow heal it. Never to suggest this is only in our minds, since, they say, attitude can even heal cancer. Also, I’d done some reiki/steam rooms, not sure how much that affected their healing. Now, I’ve just seen a credible ayurvedic doctor, he and another one, suggested ghee in my eyes (guess soothes too) He also has me put 3 drops of coconut oil in my nostrils, and take a 1/2 tspn of triphala for malabsorption, all daily. Will keep up every day, and give you results in 1-3 months. Also, I’m experimenting with Can-c drops (for cataracts which I don’t have, but also recommended for general eye care.) Feels kind of good, but couldn’t say anything more about them. I’m just working on the dull feeling and reduced vision in my eyes, a result from the years of trauma, I believe. Now, does it sound like I had a DCR? doesn’t sound like any other method. And sometimes, when I blow my nose, air seems to blow through the puncta (nothing bothersome). Luckily, I’ve not had your aforementioned side effects from it (or perhaps because the flush closing didn’t allow effects). Now, I can not imagine the ducts being very deeply scarred, as I just touched the surfaces, for a moment. And, they are open.
Your view sounds to me like the ducts are not the cause of the numbness? In fact, I realize if the upper puncta are open, the ducts would be getting some lubrication. This is fairly good news. The tearing itself, I think is not quite so bad, happens during certain activities, not even my main impetus to fully open them. Still, why not improve if I get convinced enough it can’t hurt, and may lubricate the ducts even more. The cheek numbness I can live with. Ofcourse I just feel very stagnant throughout, because of it, and psychologically/ vanity-wise, the puffing has added many years to appearance. I can imagine numbness can be from many other causes, which I really can work on. Now the doc was convinced that because of this migrating (happened I suppose because of the cauterizing/tubing) that the one-snip would open them too large?? I believe the canal is sideways, and would affect that? I wonder if this one-snip has only caused problems for people because their newly drilled artificial canals were too large, and were sucking more fluid because of that? You’re drilling sounds very promising. My very prominent oculoplast is convinced the one-snip has caused others dry eye, but again, I wonder if that’s only because they had a new larger hole drilled by the DCR? But you say they did a 3-snip? And if in fact I had a DCR, then not sure if it’s a good idea. In fact, my memory is foggy if the surgeon said he went through a natural opening or what he said,if anything. I think I have some rapport with my doc, and wish to bring these up to him. Looking forward to continue with you.
Good to hear from you Havad. Reiki and steamrooms can be useful, I’ve tried them both. I did Reiki 1 and 2 many years ago, and use a steam room when possible. The steam room is similar to “warm compresses” or using “BlephaSteam” and assists to liquefy the meibum in the eyelids.
It seems we are both fans of alternative medicine. I often hear the herb Triphala used for dry eyes (although I haven’t tried it ‘yet’). Coconut oil has a very long list of benefits and in fact, is something I’ll try next. It’s not scientifically documented so I’m not suggesting any reader use it in this way, however, with dry eyes we have little to fall back on and only have controversial treatments left. So using coconut oil by rubbing it around the eyelids (careful not to get into the eye). It’s worked for quiet a few people and the lipids within the coconut oil may seep either into the eye or via the capillaries, thus providing a lipid layer. I haven’t considered using the nostrils as a route of administration.
I’m not sure about the ghee (clarified butter). I’d imagine coconut oil has gone through less processing and more closely resembles the eyes lipid layer?
I’ve had a look at the Can-c drops you’re using. They contain a general eye lubricant so very good for dry eyes for symptomatic relief. The NAC in them as the ‘main’ ingredient promoted has been touted to help release meibum from the meibomian glands. It’s often used as a supplement for this purpose and I’m not aware how it would work as an eye drop. Perhaps you can keep us updated?
Air regurgitation through the punctae upon blowing nose is common post DCR surgery. Does your upper eyelid flutter when you blow your nose? That’s certainly an indication of DCR surgery, however, unless you have an ENT or Oculoplastic surgeon examine your nasal anatomy you’ll never know what occurred to you all those years ago. You’ll obtain a definitive answer upon examination, otherwise all we can do is speculate.
Havad, you are correct. If the punctal ducts are open, then you should be obtaining lubrication within the naso-lacrimal ducts from natural tear drainage.
Dry eyes, tearing eyes, etc all increase ‘ageing’ around the eye area. The ongoing ‘squinting’, rubbing and use of various treatments ages the eye area compared to normal eyes. It’s an ongoing problem we live with and is both physically and mentally draining. So if you can live with some numbness around the cheek area and view it as a minor problem compared to everything else then it’s one less stress to deal with.
So you seem to be in two minds about the one snip procedure. If you haven’t had DCR then you don’t have an 8-12mm hole drilled into the nasal cavity, so a larger punctum will not drain the tears too quickly. Furthermore, DCR usually involves a ‘3 snip procedure’ of the puncta rather than only one. So in that case, the one snip procedure is only very minimal, and should not drain tears away from the eye too rapidly!! (that’s the theory?). However, you are not entirely sure if you’ve had a DCR 20 yrs ago? So if you do have the one snip punctal procedure then it may result in extremely dry eyes by draining too fast through the large new opening (both punctal and nasal). This is what I understand to be your rationale, and it’s basically what I’ve explained within my verbiage on this website.
Firstly, you need to discover if you had a DCR 20 yrs ago. It’s not uncommon to have it performed on both eyes. We don’t know yet until you are accessed accurately by a reputable oculoplastic surgeon.
Secondly, you are torn with making a decision to have the one snip procedure. On that basis alone, perhaps you shouldn’t go ahead with it? The old saying is, “If in doubt, throw it out”.
Let us know what your oculoplastic surgeon discovers upon examination Havad. Did you have a DCR 20 yrs ago? Can you obtain your medical records from that time?
Again, very thoughtful considerations. Unless I’m very clear on the DCR (and will try to obtain these records) then I’ll follow along very very conservatively (as the numbness is livable) Thank you
Update: Though records are from too long, and not available, the prognosis is: I did NOT t have DCR surgery. Following was the reply (and reference to the eyelid fluttering)”This is not a DCR. Merely lacrimal tubes. Air going into your eye happens because your tear drains are open consistent with having had tubes.” Too, there was no bruising or downtime. Also a 2nd opinion claimed no a DCR was not necessary to have tubes. Now my question I need to decide is, should I have a one-snip? My eye surgeon is dead against it (though willing if I sign a waiver): Only because I ‘messed w/the ducts so much, the physiology of it is compromised.’ Other docs confirmed it has scarred over, and another teeny hole has opened in another location?? I personally think the tubes/self-cauterizing maybe slanted the canal to a diagonal. it’s the same hole. He claims 1 or 3 snips have not fixed problems before, and either it’ll possibly scar over, or enlargen too much. My impetus is my theory: the numbing/slight puffiness in cheeks, which btw, have sort of stayed the same/or just slightly gotten better, since I last wrote. I’ll give this time, but will probably do nothing. (side note, if you recall, the ghee, not good in eyes). Again, all the best to you, Havad
Hi Havad, Thank-you for the update and progress. You are making the correct decision to leave it all alone. That’s the advice your doctor is also providing you so you can rest assured you’ve done all you can do for now. The best you can do for yourself is symptom relief, believe in your faith that God will look after you and allow time to be a healer. All the very best.
I had a DCR in sept 2014. It it now January and I still have swelling, pain and redness. It is painful to wear my glasses too.Anybody know how long before this goes away? I asked my doctor and he said it takes time.
Hi Helen, I’m assuming you’ve had an ‘external DCR’ since it’s painful to wear glasses. So we are talking about the healing of the bone removal on the side of your nose? I’d imagine it should be relatively healed enough to wear glasses by now. However, I would seek a second opinion from another surgeon.
I went to my ENT doctor and he told me it is a cyst that formed from having the surgery. He told me to go back to the eye doctor because I need another surgery to remove it. So I am going Tuesday.
Thanks for letting us know Helen. Hopefully they should be able to deal with the cyst with minimal scarring. All the very best with it and please let us know the outcome of the surgery.
hi i had dcr 2 weeks ago, tube in my aye and nose is poking me so that i am tearing and watery nose, is there any solution for that
The tubing should pass through as a loop from the upper and lower puncta. It shouldn’t be poking you but it can still rub on the eye a bit and be uncomfortable. I’d suggest you see your surgeon and have it adjusted.
I had a DCR to both eyes on 16/11/14 about 8 days later a plug looking thing came out of the right side and since then I have seen my doctor and have had the tubes removed my problem is that nothing comes out the left side except fine watery mucus and the right side side has yellow mucus and large scab looking pieces the size of a finger nail ,also I think it might smell strange
Wow – a DCR on both eyes is extreme! It sounds like the right side is infected.
Hello, I live in France and have been diagnosed with blocked tear ducts since Summer 2012. Autumn 2015 I had an external DCR in both eyes,( the two eye operations were 4 days apart) and I have a few questions which I hope you may be able to help me with.
First though,briefly to explain how I came to need a DCR op, In April 2013 my French ENT doctor tried putting stents in, but this was only successful in the left eye, the right eye was more complicated and he only managed a stent in the lower tear duct. Due to the forcing on my right eye, I had hematomas lasting 13 days, and to this day I’ve been left rather numb in my upper right lip and lower right nostril, a pins and needles sensation. I mentioned this but was promptly told it would diminish in time. Stent removal was in December 2013 on my request due to constant tears, eye mucus and General eye discomfort. In June 2014 I was instructed to have the DCR eye dye test by my ENT doctor to find out cause of the problem, and this was done in the same hospital. Well, after the eye scan the doctors could not perform the eye dye test because both eyes were so blocked the dye spurted out everywhere. I Was told this was the first time ever that they had not been able to fully carry out the dye part of the eye test. My ENT doctor referred me to a very notable tear specialist in a large city an hour away. First appointment with this specialist was in September 2014 who suggested in my case an external DCR operation may be able to help, but it was pointed out that if I didn’t try then I would still cry endless tears.Even in the Summer, yes I cry all day every day, but less in warmer temperatures. So in October 2014, left eye operation first, four days later, my right eye.
Nasal scarring isn’t too bad quite good actually, but obviously side on view the scars are much more visible. No post operative complications other than the the fact I was still crying, I thought the operation would put a stop to that! In November 2014 I had a small eye infection which with eye antibiotics cleared up.In December the tube in my left eye was digging in to my eye, making it red and sore, and difficult to turn my eye to the left. My new eye specialist operated the next day, inserted a new tube and with one small stitch, stitched it to the end of my lower eye tear duct, presumably to keep it in place. Over Christmas the tube came loose again, totally misplaced,fully visible but actually didn’t hurt, but it was removed in the opthalmo centre immediately by my surgeon. He said he needs to insert yet another tube, this will happen next week!
My problem is that my French is good but I don’ t fully understand what is going on, he mentioned something about being curved, hence this tube problem, but what is curved? I don’t understand when he answers my questions, it ‘ s fairly in depth eye info here all in French. What I will add is that my right eye has improved but I still cry,in both eyes. My question is, why more my tubing? Why a problem in left eye? Should I still be crying as much as this? He told me it can take 6 months for the new tear drainage system to work, is this true, or is this a case of a failed DCR? I’m worried how many more operations I’m going to need? It sounds like a lifelong commitment to eye tubes, I’m just turning 49, and imagining hankies for life , even food shopping is awkward, in the fresh aisles, buying butter, cheese etc, I look the saddest person I the works wiping my tears! Well I’m not actually, I love tto have a laugh! Do I need a second DCR?
Your reply will be greatly appreciated, thank you.
Hi Linda,
Sorry for the delay in replying. Were the stents placed into our nasao-lacrimal ducts? If so, we’d like to know the location and name of that doctor since many people with epiphora get thrown into DCR and find it very difficult to locate someone willing to use stenting. Okay, so assuming you had stents placed into your naso-lacrimal ducts to ‘allow tear drainage’, it seems it only worked in the Left eye. Did he “only manage to stent in the lower ducts” of BOTH eyes?.
Hematomas are a rare complication, but I cannot advice because I don’t quiet have the full story. It’s not “Jones tubes” you were having inserted, but definaely “stenting”…correct? And I’d like to know exactly where both stents were placed. I’ve heard cases of numbness and pins and needles sensations after such procedures many times and more often than not they do improve slowly over time. Not to worry too much about that. Please do massage around those areas to stimulate the nerves and blood supply and use Vitamin B12 for nerve function.
Did you have the stents removed from BOTH ducts? I can’t understand how the dye spurted out and you couldn’t have the scan done. The scan, if I’m correct, is a Macrodacrocystogram and the dye is actually a form of vegetable oil. Everyone who has it performed for a “blocked tear duct” would have regurgitation of the oil/dye. The trick is not to put so much in there to cause it to spurt out, and if it spurts out then enough was squeezed into your Naso-lacrimal ducts to reveal where the blockage is in the X-ray. That is very odd indeed. Have it done again, or go somewhere else!!
So you have an External DCR on both eyes and still have tearing. I’d recommend to wait until the tubing is removed (the tubing keeps the hole they drilled into your nasal mucosa open).I know when they removed mine after 6 week, I got the opposite and become bone dry. That’s where my own problems started and got worse from there. But you are different, with a different ’cause’ to your tearing.
The tubing certainly does rub on the eye, especially when looking to the side. I’m sorry you got an infection, but I don’t understand what operation they used? If they needed to replace the tubing they remove it through the nostrils with tweezers and then go in through your punctums to place new bicanicular tubing. I can understand the ‘stitch’ will keep it in place and I had the same offered to me but it was for a “plug” used in dry eyes to retain tears (rather than avoid them). So you had a THIRD bicanicular tubing inserted? How can it come loose three times? It’s either your anatomical structure is slightly curved and causing problems with keeping the tubing in place or the material of the tubing is not working for you.
Wait until both tubings are removed before you begin to worry about tearing. It may clear up then. But yes DCR an fail because we can heal too fast and cause scar tissue to block the ‘hole’ they drill into your nasal cavity to form the artificial tear drainage system.
So do you still have the tubing in your eyes? Can you please ask your surgeon for the name of the tubing? For now, I’d recommend placing some vaseline under your eyes where the tears roll down to avoid it dripping down your face. I found Bleph10 (an antibiotic drop) helped reduce my tearing and antihistamine drops…give them ago whilst a more permanent solution is sort.
Keep us posted and good luck Linda!!
Many thanks for your honesty about Endoscopic DCR. I had the same surgery and believe that it is too invasive and should not be done. I agree; the surgeons do not explain well the details and side effects of the surgery.
I do not like the removal of the bone from the nasal cavity. Luckily, for me the operation worked only for three months because the punctum naturally blocked, consequently, I no longer feel the fluttering. I was told this occurs in about 5% of the cases. I see this as a blessing. My eye still tears but this discomfort is tolerable compared to the fluttering. Unfortunately, what’s done cannot be undone. Yes, I agree the medical community should not encourage this surgery. If I had known about the complications, and understood well the procedure, I would not have consented to the surgery. Finally, I have decided to live with the discomfort and not to allow a second operation.
Your voice speaks for so many of us who are disappointed about the Endoscopic DCR surgery. I hope the medical community is listening. This operation has too many risks.
i had my DCR 3 days ago (11/3/15) and discharged on the next day. However I started to have swelling on the left side of my eye/face upon being discharged. I barely can get out of bed as the affected area is also throbbing. I have been prescribed maxitrol eye drops and also CMC ointment (QID). Please kindly advise on what is going on and how can I treat this.
I’m sorry to hear you’ve had such a reaction to the DCR surgery. Did you have an external or endoscopic DCR?…it sounds like an infection and if they’ve issued you with anti-biotics it may resolve itself. Let’s hope it passes quickly. I wish you had found my site before deciding to have the surgery. Best of luck.
I had a DCR on right eye 3 days ago. I began having floaters on the evening of surgery. The floaters have increased in size and number. My eye is very sensitive to sunlight. Is this common after a DCR?
Hi Mary,
Anything is possible after DCR. Whilst floaters occur on most people, with or without a DCR, any operation near the eye area could possibly stimulate floaters. I see lots of them and can’t recall if they got worse after my DCR operation which was in 2007.
The eyeball is filled with a “gel” (vitreous body). Small specks of this gel solidifies and ‘clouds’ causing a shadow effect on the retina and that’s what we notice as a floater. Is it possible when the eyeball is squeezed, pressed and moved around a lot to interfere with the balance of gel that fills the eyeball? The older we get the gel thickens, so pressing on it may cause parts to solidify? I’m just throwing thoughts in the air here because a DCR doesn’t involve an operation on the eyeball itself. It would depend if the surgeon manipulates the eyeball much during the DCR to keep it out of the way.
Let’s hope the floaters settle down over time and you are not as aware of them.
Sensitivity to sunlight after such a procedure is common. It will hopefully settle down. Please do keep us informed with your healing progress, thanks.
Hi may name is Niema ! I had DCR surgery on my right eye. The surgery was taken on first week of April and I had fellow up check up a month after surgery, so after he checked it , he told me “it is healing well so we will remove it after one month”. But in the last three days I am getting white –yellowish colour mucus around my eye where the tube is. So is it normal or I should see the doctor? Thanks
Hello,
I had external dcr surgery about 6 weeks ago with a silicone tube out in.
I had the stitches out and it checked about 2 weeks after and they said it looked fine.
However now the tubing has really started to irritate my eye and the skin around the lower puncta seems very inflamed and is sticking out about half way up the tube so there is almost no gap in-between the top and bottom puncta, i am due to have it out next week but it is causing me no end of irritation and my eye is constantly watering and stinging?
Do you think i should try and see them sooner?
I would really appreciate your input.
Thank you
Hi Ellie, Very sorry for the late reply. I was in the amazon jungle during the time you wrote without any internet access. I’d guess you’ve had the problem resolved now? Perhaps they issues you with steroid drops or replaced the tubing? Whatever they did, I hope it worked out for you and wish you a speedy and successful recovery.
Hi I am 20 years old and had endonasal DCR surgery. My eye was fine until two days ago, the corner of my eye where the stent is, has been getting really pink/red. Is this due to irritation from the stent? And is it normal? Also, I think the other end of the silicone tube is hanging loose in my nose? Is that how it’s supposed to be?
Sorry for all the questions, I’m pretty concerned.
Hi Harjot. It’s difficult to determine. It could be the irritation form the tubing on your skin or a possible infection. I’d suggest you consult your eye specialist for an evaluation.
I had left tear duct replacement surgery on Oct. 20. Saw surgeon 3 days later, things were fine. Six days ago, started having severe pain around left eye; has now become excruciating pain on entire left side as well as entire head from forehead thru top & around to back of head. Worse than migraines. Saw family doc today since surgeon is 2 1/2 hours away. My doc talked to surgeon; they started antibiotics & I will see surgeon Friday. How serious could an infection be? And what type might it be this close to the brain?
Hi Anna, Often terms get mixed up. DCR surgery isn’t “tear duct replacement surgery”, that’s more likely to be a Lester Jones tube insertion that replaces a damaged canaliculus. So I’m not sure at all what you are referring too. DCR creates a ‘new’ opening, an ‘alternative’ opening that’s drilled through the nasal bone into the nose to allow the tears to drain, thus bypassing the ‘blocked’ duct. So it’s not actually replacing anything.
So you only had the surgery 10 days ago and experiencing excruciating pain worse than a migraine. Anyone who suffers migraines will know how serious your pain is!! They are assuming it’s an infection? We can only hope the antibiotics work. It’s difficult to travel 2.5 hours to see the original surgeon, I understand since most of my specialists are the same distance.
An infection can always be cleared up. It can also stir blood vessels that constrict then over dilate causing migraine headaches. It’s a cascade of events and until you see your surgeon we can only speculate. Let’s hope it’s only a minor problem and will be cleared up for you very soon. Please keep us informed.
after DCR surgery, I blew my nose. 100 times a day so went to war, nose, throat doc. Had CT scan on sinuses. It was discovered that the bone around eye, the side closes to the nose was gone and my part of my eye was merged into sinus area. Dr did NOT tell me he was removing bone.
I have never seen anything in all DCR info about removing this bone.
Any explanation???!
Hi Sherry. The surgeons whom perform DCR are all different in their approach. Many purposely don’t tell you they remove bone and it involves “drilling”. In fact, an oculoplastic surgeon told me he never tells his patients he removes bone because it frightens them away from wanting the surgery!! I had seen 4 oculoplastic surgeons before having my DCR and only one of them mentioned bone removal with “External DCR”. However, the surgeon whom eventually performed my “Endoscopic DCR” made it sound as if he was going directly into the tear sac through the inside of the nose, thus no hole was required. I trusted him. Should we trust them? Should we do some of our own research and look it up on the web? Of course we should but we tend to trust them too much and are desperate for relief.
I was furious when I discovered apart of my anatomy was removed without my knowledge. I felt violated. And indeed it is a violation when they fail to disclose such information before surgery.
What country are you in Sherry?
Hi,
I live in Colorado, USA.
I think the Dr. caused my lamina papryacea to be punctured and fell apart during the DCR surgery. A big medical mistake!!!
To tell you a bit more, I had DCR surgery on both eyes a week apart. The Dr, removed the stent from the left eye keeping the right stent in for some time. My left eye watered all the time, so the surgery did not work. I also had what is known as a wedge in the right area between my eye and nose. It is awful, and makes my eye look different. He said it was scar tissue. HUH? How could scar tissue be that far up when the incision was nowhere near there but further down. He then put a needle in that area to numb it before he put another needle in of something to try to break up the scar tissue. I came unglued with the pain. I have had 4 children and the pain was the worst thing I have ever experienced. He then yelled at me to be quiet as he had patients in the waiting room. I did not go back to this DR!!! Also I found out he did middle turbinectomy on both sides which he did not tell me he was going to do. All he said to me was a small incision and place in a stent. I then had to find another surgeon to have the right stent removed. He removed it and suggested I have a Jones Tube put in my left eye which was still watering a lot, It has helped to some degree, but I don’t think anything can ever clear all this up., My sinuses are screwed and who knows about my eye contents slipping down into my sinuses because of the bone missing. I did read where if bacteria gets in the sinus, it can now go into my eye and cause blindness. I really think medical malpractice might be looked at here.
Thanks for the extra info Sherry. I’d recommend you check your options for malpractice. There are too many cowboy surgeons throwing people into unnecessary surgical procedures and I believe DCR is one of them. Legally it can get messy and they often go by the percentage of injury. It sounds like they really made a mess of you and the problem cascaded out of control.
Perhaps you may like to add your opinion on my website segment: “Arrogant and Inappropriate Medical Professionals” http://www.blockedtearductsurgeryadult.com/?p=91
Please keep us informed with your progress.
Hello, it’e almost been 2 months since I’ve had my DCR. Before surgery, my eyes teared (mostly my right) and caused a lot of my eyelashes to fall out. After the surgery, my right eye has still been watering. On top of that my right eye still remains a little swollen with dark, dryness on my eyelid, inner corner of my eye, and under my eye. I kept asking my doctor about it but he kept telling me that the dryness was being caused by the tearing. Do you have any explanations as to why this might have happened? I feel as though the DCR did not help me at all.
Hi Sharon thanks for writing in. Sounds like you had an unsuccessful DCR, it should not be tearing at all 2 months post surgery. Your surgeon’s normal protocol would suggest to have a second DCR. I’m not sure if the tearing would cause the eyelids to fall out. Were you wearing any make up such as mascara or applying eyedrops? Those can be likely culprits. The dark, dryness on the eyelid and inner corner of the eye is very common when you’ve had epiphora (tearing) for awhile. Salty tears tends to irritate the delicate, thin skin around the eyelids and corners of your eyes. It can make your eye look aged.
What did your surgeon suggest as a viable solution? Do you want another DCR?
Hi George!
I haven’t applied mascara onto my eyes prior to the surgery, my eyelashes were just drying up. The dark, dryness that I’ve been experience on my eyelid, inner corner of my eye, and under my eye actually started after my surgery, it seems like the inner corner of my eye is scarred, but my procedure wasn’t done externally.
I haven’t seen my surgeon yet but I do not want another DCR. I’ve had an allergist tell me that I’m allergic to dust and my eyes are sensitive to weather changes. I’ve also had an ophthalmologist tell me that I have dry eye. I let my surgeon know about these issues beforehand and even after probing procedures he suggested the dcr surgery for me. I really don’t know what’s wrong. I’ll be making a follow-up appointment with him soon.
Thank you!
Dear George,I have just read about what can go wrong with a DCR procedure.
I visited a Dr last friday and he just about convinced me to have it done.
I was told the proceduce is nothing and the only thing that could go wrong is if there were still too many tears after the stents were removed.but it would then be done again.
I have been trying to get information on the net since friday ,i am a dummy using computers and nearly a dummy to have been taken in by my charming Doctor,
My son was with me at all times ,my eyes tear all day every day and i have tried most drops ,gels,etc.
Your site was like Manna from heaven for me,thank you so much.
I had major lung surgery 3 years ago and i explained that to the Dr but he said, i would be in and out in minutes.He said if i didnt do it soon i would have bags under my eyes that would reach my chin.No woman wants to hear that.
The world needs people like yourself.
Valerie
Hi Valerie, I’m glad you found my site just on time! It seems that particular surgeon was rather insistent and really wanted your business! He also seemed to be watering down the surgery by his suggestion “you’ll be in and out in minutes”…it takes at least 1 hour to do a proper DCR. I believe it’s longer if the endoscopic procedure is used. Did he give you the option of the two types of DCR surgery?
Regardless, the condition still requires treatment and relief. I’d encourage you to find a surgeon whom will use the non-invasive procedures outlined in my website.
Good luck and let us know if you go ahead with anything.
Dear George,
Thank you for your website. I have had watery eyes for several years, and after going through the various procedures including dacryocystogram, When the report came back it read……”they cannulated the inferior canaliculus and found a marked irregularity and a moderate stenosis at the lower end of the nasolacrimal duct”.+ There is ”fairly prompt clearance of contrast into the nose”.
Endonasl.DCR was recommended.
I started to do some research and came across your website …. After reading through I have opted to hold off having any surgery so I can review other options. The idea of having ones bone drilled in what is a highly sensitive and delicate area is very scary, and some of the post surgery complications I have read on here are even scarier!
The Endoscopic Nasolacrimal Duct Intubation was not mentioned at my consultation)….as there appears to be no bone cutting or drilling.
Is ENDI in your opinion a safer, more successful procedure? Would that work with the blockage as described above?
Thank you again for a most informative site… I will continue to explore and research. You come across as a genuine and caring person….you should have been a doctor – clearly the profession needs people like you!! P.S I’m in the UK…Kind Regards,
Hi Lesley,
The ENDI does sound like a perfect solution. Yes it’s safe if they are just threading the tube through the natural naso-lacrimal duct. The idea is to have it in place for quiet awhile to allow a lining to grow around it and forming a channel that will remain open when it’s removed.
I do not understand why they keep insisting upon DCR when safer options are available. Good on you for doing your research and being skeptical. Take the information to your surgeon and inquire about the ENDI and he’ll probably tell you it’s only for a “partial” blockage. But why not give it a go? Partial or full blockage shouldn’t define whether someone can have a safer procedure.
Good luck in your search.
Thank you George, that is most helpful.
Good luck to you also, keep up the good work.
Kind Regards,
Lesley
Just had the e n d I procedure done 4 days ago on both eyes. Right eye healing well as is left eye but on the left eye the lip of the tube is rubbing my eyeball when I gaze to the right. Is this something I should tell my surgeon about? Is this typical? I am not due for a follow up appt for 10 days.
Advise?
Hi Belinda. Is that the Endonasal DCR or just the tubing placed without the DCR? I’ll assume you’ve had a DCR on both eyes (forgive me if I’m wrong). Okay, the tubing can rub on your eyes when you look sideways but it doesn’t have to be that way. Perhaps it’s a bit loose. You need to see the surgeon about it. Many people experience the same ‘rubbing of tubing’ on the eyeball after DCR so it’s quiet normal. Many people with ‘dry eye’ have punctal plugs inserted and they feel it touch their eyeball when looking sideways.
The tubing will come out in a few weeks, but I understand how uncomfortable the ‘rubbing’ sensation is. If you were given antibiotic ointment…place plenty of it around the tubing so it’s more lubricant and not ‘dragging’ on the eyeball. Or you can purchase ‘Poly Visc’ from a pharmacy which is a dry eye ointment that’s rather thick and should relieve the sensation for you. That should hold you over the 10 days until your next appointment.
All the best for a speedy recovery.
I had DCR just over a week ago. I am very dizzy – think I have developed an inner ear infection. Also noticed that my tube is no longer clear and looks to be filled with blood. Is this normal?
Hi Tracy…inner ear infections and dizziness usually go together. It’s not normal to see blood in the tubing. Please consult your surgeon as soon as possible.
I had internal dcr surgery 10 years ago , it never did work so this past December 2015 I had external dcr , my right is still waters!! Any suggestions? I can’t cope with it any longer, my eye stays so irritated and raw from wiping tears! Thanks!! Helen Mullins
Hi Helen, so you’ve had an internal and external DCR on your right eye. Both unsuccessful. This is not uncommon and I’ve received many emails from people in the same position as you. However, that’s of no comfort when you are frustrated with the watery eye. Have you checked out the “alternative” methods I mention on my site? They are another avenue for you.
Meanwhile use some antihistamine drops to try and dry the eye out, put vaseline around the corner of your nose to prevent tears rolling down your face and if you notice any sign of infection obtain an over the counter antibiotic drop such as Bleph10.
I will be looking into eyedrops and products people can buy to cope with watery ‘and’ dry eye and place them on this site. It will take time to research the most effective solutions, so stay tuned for that in the future!
All the best in good health.
I had the DCR stent removal and it was a horrible pain I never felt before 3 days ago.im glad I did it but if I known it was going to be that bad I wouldn’t have done it. Now I still can see the stent sill in my eye
I am scheduled for right eye DCR surgery this Monday ( April 18) morning. I am very hesitant to have this surgery but I do not want to continue to take antibiotics for the painful infections that keep reoccurring in this eye. I have eye ache with some sinus pressures around the eye now. I asked about alternative procedures and oculoplastic surgeon tells me that they really don’t work and I’ll just end up having the DCR anyway. He is not pressuring me and tells me that it is fine to hold off getting the surgery if I want. I will be traveling to a middle eastern country this summer with plans to stay there for some time. I was wondering if I should just wait to have this surgery after I see how dry my eyes may become once I get there. Symptoms during summer weather has been better for my blocked tear duct in the past. Right eye is partially blocked and left eye is starting to show signs of blockage. Any insight would be great. Are there any success stories out there??
Hi Acat…you have a luxury many of us didn’t have prior to our DCR surgeries and that’s ‘forewarning’. This site outlines the risks to a degree you won’t receive from your surgeon. But you are in the dilemma with infections from the watering eye and need a solution! It’s like being stuck between a rock and a hard place. We understand.
Yes there have certainly been success stories with the alternatives to DCR and I personally disagree how surgeons easily dismiss them. In fact they should be the first line of treatment and the invasive DCR last! That’s my view and not everyone will agree. It’s really up to you to weigh the odds up between risk and benefit.
Not everyone has significant complications after DCR. In fact, sometimes the surgery doesn’t work, and often a second DCR is recommended. Maybe you don’t have the time to find a surgeon willing to offer alternatives and just prefer to jump into DCR since it’s being offered? You are going overseas which complicates the matter too and you’d prefer to be ‘fixed up’ before leaving.
On this note, I’ll leave with saying… It’s your decision. Chose wisely.
Thank you for the words. I will update as I am able. Have a nice day!
Update: I cancelled my surgery that was scheduled for Monday. I have an appointment with another doctor on the 27th of this month and I have stressed that I would like to explore alternative solutions. I forgot to mention that my eye is tearing during the day and then becomes dry at night. I wear contacts. Does anyone else experience dry eye in the evening and during the night combined with a blocked tear duct?
All of the above. For over 12 years. I had a double external DCR on April 29. All problems have vanished. The stent or tubes don’t bother me at all. I do feel an occasional tickle in my nose. I haven’t had a tearing problem since the surgery. I intentionally seek my former “worse places”. So far, so good. By the way, the surgery was nothing, but nothing to worry about.
I had Endo DCR in my right eye 6 days ago. I’m still in alot of pain from my head to my teeth. Went to the dr 4 days post op for the pain & bleeding he said there’s a blood clot hematoma at the site on my nose by the eye. Told to massage (which hurts like hell) & apply heat. Is all this normal? Should I go back to the dr? I don’t think I should be in this much pain.
Hi Jamie, is the doctor you saw for the pain the same doctor who did your DCR? Basically, the bodies fibrinogen system will break up a clot itself and that’s what your doctor is possibly thinking. However, I can’t see how massaging an excruciatingly painful area is going to help.
There are blood tests and scans to diagnose a clot, the size, shape and area of the clot can be determined precisely. Depending on how large the clot is, if there’s more than one, etc you’ll be given an injection of clexane.
Yes it was the same dr. I’m going to see him again tomorrow morning to see if it’s gotten any better. I had no idea it would be this painful. In fact he told me I would only be out of work for 3-4 days. Is the pain in my teeth common?
Hi Jamie, No it’s not common at all to be that painful. An external DCR is usually more painful. I didn’t recall any discomfort at all apart from a lot of bleeding when I had my endoscopic DCR.
However, the nerves that surround the eye and cause eye pain are the same branch of nerves that surround your teethe.They are branches of the trigeminal nerve. So it could be possible that the branch of nerve that goes to your teethe, the ‘mandibular nerve’ could have been aggravated during the DCR. If that’s occured I’m not sure if it will settle down or require intervention.
Where is the pain from 1 to 10, 10 being the worst? Does the pain radiate anywhere or is it in one spot? Is it worse when you chew? What aggravates it?
Your doctor may issue you with a strong opioid pain killer and possibly Lyrica and hopefully do some investigative testing.
Let us know how you go! and luck with your appointment!
Well my appt yesterday was interesting. I’m in so much pain because of a broken bone next to my nose under my eye, near where the blood clot was. Dr is baffled by this finding. I guess it wasn’t visable due to all the swelling when I saw him on Monday. He seemed concerned because it is nowhere near where he worked (more in the corner of my eye) He said the blood clot was getting smaller. My tooth pain has stopped. Now the majority of my pain is where the bone is. The dr did say he will fix it. I’m just concerned as to why I have a random broken bone & how it happened. The dr did say that this has been one problem after another especially doing it thru the nose.
I am almost 5 weeks post op, and have started noticing a problem. When I blow my nose, very gently, it blows out my eye! Of course, it is a holiday weekend, probably will not hear anything before Tues. Has anyone else experienced, and should I be calling the emergency number?
Hi Carolyn, thank-you for writing to us. The regurgitation of air through the corner of your eye is a very common complication with DCR surgery. It can occur up to 40% of people. If you read through my blog I’ve also had the same complication. It’s very annoying and whilst they consider it normal, they don’t find it necessary to inform you about the complication before surgery. I disagree!! If it’s such a common complication, we should know about it.
The problem was occurring with me during normal breathing. It’s like the corner of the eye puffs in and out with the air passing through from the nasal cavity through the tear duct onto the eye surface. It’s very disconcerting. Surgeons see it as harmless and trivial.
I’ve heard of a case with a guy who had DCR and uses a sleep apnea machine. The air was blowing strongly onto his eyeball by the machine causing horrific pain. The only solution was for his surgeon to cauterize the puncta.
Carolyn, now that you know it’s a normal occurrence you need not worry. I found it eases off with time as the DCR hole slightly reduces in size.
Wishing you continued improvement with your eye.
Thank you for this info. I ended up in ER on Sunday am for head pain and general discomfort. The tube was still in place. I was given anitibotic eye drops for the inflammation, and an ointment for bedtime. Also on Benadryl and Sudafed to dry out my head so I don’t need to blow my nose. Hopefully, tomorrow, the stitch will come out at my scheduled check-up, keeping it from irritating the eyeball.
Thanks for the update Carolyn. It’s good to know the tube was still in place and soon it will be removed. Every surgeon is different with how long it remains in place usually between 4-8 weeks (median time about 6 weeks).
I’ve had stitches in the eyelid that rubbed on the eyeball, so I feel your discomfort. Let’s hope it’s removed soon!
It was great to be placed on medicine to dry your nose up to prevent the need and desire to blow your nose. It’s not a good place to be in whilst the tubing is in place. I couldn’t wait for mine to be removed.
You’re at the tail end of it now so hopefully everything should go without complications. Do keep us updated with any changes. Best of luck!
Had mine done beginning of May. I have comments on this site. How internal dcr tubes came out in two days. External dcr on right eye and had to have tube removed in one week. I also have air thru tear duct when I blow my Nose. Dr. Said that’s normal. Asked if anyone had tubes removed so soon. Dr. Said No, I was the first. That didn’t make me feel to good about the operation.
Hi M.P. …. sorry for the late reply. I sometimes miss emails amongst over 100 emails I receive daily. Many are spam mail and can’t seem to stop them!!
Okay, How is your DCR healing since May? If your DCR tubes came out after two days post surgically, then the tissue surrounding the osteum (hole drilled through the bone) will usually close up. It’s the bodies natural attempt to heal itself. Many people require a second DCR due to this problem occurring. I’m uncertain what you are saying – did your surgeon remove the tubes two days after surgery? Or did the tubing dislodge itself?.
The tubing forms aloop through both upper and lower ducts and rests within the nostril cavity. I guess hard blowing of the nose may dislodge it? Or the surgeon made an error? Regardless of the cause, it shouldn’t have been removed after two days.
Indeed, your surgeon is correct, a large proportion of DCR surgeries cause air regurgitation and a fluttering of the eyelid when blowing the nose. I have it and don’t like the feeling. You can prevent it by pressing your finger on the upper duct (to block it) when blowing your nose. I had my DCR 9 yrs ago and the air regurgitation has settled down a bit more. I used to get it whilst breathing, every breath in and every breath out I’d feel air on my eyeball. It was so awful I went to many other surgeons to fix it. The only solution was to place a ‘punctal plug’ in the punctum. Rather, I had both lower ducts cauterized because of ‘dry eye’ so the air regurgitation is less now.
Please let us know how you are getting on now. Thanks for writing and sharing.
Thanks for your interest. The left eye was internal dcr. It came out of the tear duct itself. The dr. Did my surgery was not available, so her associate put it back in., when I got home it was out ,so next day I went back and he removed it second day after surgery. The right eye external dcr. Removed bone, tube got misplaced and was in the middle of my eye,so original woman Dr. Did surgery, removed it by pulling thru tear duct,said couldn’t find it in nose.It was in one week,I asked her if it would be OK,she replied that some Dr. That do bone remova,l sometimes don’t use the tube. I wasn’t pleased with that answer.I asked about the knot, that I thought she said she couldn’t find, she replied ,she didn’t have a knot in my nose. I also asked at my final visit ,if this happened before she said, yes. I asked ,That Soon? She said I was her first patient that ,it came out that soon. She said, just some bodies reject them.Told me to use artificial tears. Having few issues trying to wear contacts. Hoping it I don’t need surgery again, not so sure I would do it. I wouldn’t go back to woman Dr. I should of looked at their reviews first,her associate had a lot more experience in dcr. Her speciality I learned later was for eye lid and another type of surgery.
I had same problem.. I went back and the tube was removed. It got displaced,was in the middle of my eyeball ,was in only one week. I also have a hard lump under my eye from external dcr.
Wow M.P. you’ve had some really bad luck there. Your surgeon is probably correct you’ve been her only patient where the tube displaced itself so quickly and your body rejected it.
A good surgeon should’ve been able to find the tubing! I know some very good surgeons here in Australia who do “exploratory” surgery in the ‘lacrimal anatomy’ to find missing “punctal plugs” that have migrated inside the lacrimal sac. They do a fine job, so I’m dubious with regards to your surgeons skills.
I’d also caution you against wearing contact lenses. They have been the cause of permanent chronic ‘dry eye’ for many people. If you ever get chronic ‘dry eyes’, that’s another type of hell you don’t want to deal with because it’s not curable and very difficult to manage. Please use glasses instead.
I understand about the lump under your eye for external DCR. Some people heal very well from it, others don’t. It’s more invasive than Endonasal DCR and you’re left with a slight scar (most people can’t notice it). Try massaging the lump to soften it and seek further opinion with ‘another’ surgeon to remedy the lump. Your face is always noticeable so ‘lumps and bumps’ need to be sorted out and we all take pride in our appearance.
Please keep us up to date with your recovery and progress. Thanks for writing and we all wish you a speedy recovery. Good luck!
I had external DCR surgery on my right eye 3 weeks ago, i had to go back the day after surgery due to severe pain on my eyeball. I had 2 abrasions on my eyeball, they fitted an eye bandage and changed my medication. To be honest the pin has reduced but is still really uncomfortable as the tube is catching my eyeball which is making the watering even worse than before, this is giving me blurred/double vision i also have quite a large hard lump under my eye. I m due to have the tubes removed in 2 weeks but wonder if i should go back now ?
I had same problem.. I went back and the tube was removed. It got displaced,was in the middle of my eyeball ,was in only one week. I also have a hard lump under my eye from external dcr.
Following DCR on my left eye, forgot and blew my nose and the lower skin of my eyelid became extremely swollen with what seems like fluid buildup, what is causing this?
Hi Liz, air regurgitation is one of the side effects of DCR. I had my DCR 9 yrs ago and still have to block the upper puncta with my finger to blow my nose because I hate the sensation of the eyelid fluttering. So you blew your nose and probably disturbed some tissue and it became inflamed. I can’t say for certain what the fluid build up is, what colour is the fluid? Is it runny or thick? Usually yellowish or greeny colour will indicate infection and clear fluid is okay.
So you’ve only just had a DCR and have the tubing in your duct? I’m assuming you’ve been given steroid drops to prevent infection post surgically? If you have steroid drops, they should help settle down the slight irritation caused from blowing your nose. I’m sure it will be okay. Keep an eye on it over the next few days, if it gets worse please see your surgeon for further opinion and a treatment plan.
Let us know how you get on and may your DCR be successful and heal rapidly. Good luck Liz!
I had a DCR external on June 21, 2016. The stent is still in and the surgeon said it need to be in another 4 more weeks. My left eye is still watering. I had scaring from the stones that were building up
in my left tear duct and my left eye was getting infected and red. I post-phoned the surgery for an entire
year (was scared never had surgery before 55 years old) I am hoping the tearing will stop. No complications (thank the Lord). I will wait and see when the tubing is removed how will my eye feel, though I do have the scar which is kinda hard. please advise what to do with that> also I had an opthomologist treat me for 6 months saying I had pink eye lol!!!
Thank you for your blog it has been very helpful.
sonya from new york
Hi Sonya, the tubing (or ‘stenting’ as you put it) blocks the punctum for a few weeks and can cause tearing. So wait until the tubing is removed and see what happens.
With regards to the scarring, you say it’s from built up stones. So the scarring is not something you can notice from the outside? In what way is the scarring bothering you? How is it a problem for you?
Hello George, last week I was diagnosed with dacryocystitis (inflammation of the tear sac). I took antibiotics for about a week, which helped me a lot. Inflammation and infection are almost gone, but I have an appointment on the 1st of September 2016, with a specialist of DCR surgery. Today I had a follow-up of the dacryocystitis, in which the eye doctor told me that I probably will need a DCR because the tear canal of my right eye isn’t functioning as it should which can result in a future episode of dacryocystitis. Dacryocystitis was the worst experience of my life.
I recently stumbled upon this website, and I am quite scared of the major complications this surgery can cause. Any advise? I hope to hear from you soon, as I will be forced to take a decision soon.
P.S. I am a male of 23 years old.
Hi Mitch, so sorry for the delay in answering your question. I’ve been away for two weeks and haven’t received email notifications from this site. My main concern is HAVE YOU SEEN THE DOCTOR SINCE YOU WROTE TO ME? Well, it often takes months to be booked into surgery so I’m guessing you haven’t had DCR yet. My personal opinion is NOT to have DCR surgery. It’s a surgery that radically changes the structure of your nasal system and there is no reversal of the operation if it goes wrong. You may have read all the many possible complications that can go wrong with this surgery on my site.
Dacryocystitis occurs from pooling of tears in the tear sac because there’s a possible blockage in the nasal-lacrimal duct. The pooling of tears is akin to a pond, there’s no moving of the water to fill it with fresh and clean water. It’s stagnant, bacteria builds and thus infection occurs. The solution is to fix the cause…unblock the channel the tears need to drain through. Please read the non-invasive alternatives to DCR which are safer. The problem is finding an eye surgeon to perform it. They want to directly offer DCR.
You’re only 23 and have your whole life ahead of you. Mitch you don’t want to risk complications from DCR that will remain with you for the next 70 yrs. Please put the effort into finding a conservative surgeon whom will “listen” and understand your concerns and do as you ask. They are out there, you just have to find them. To give you more perspective, I had DCR in 2007 and it caused multiple problems. The worst was severe dry eye and over the following five years I’ve spent $25,000 on dry eye treatment and seen dry eye specialists all over the country. Did I find a cure…not at all. Again, the complications are permanent.
Please write back to us and let us know how your progress is going.
Hi
I had a DCR on my right eye 3 weeks ago. When I move my eye to the left I can feel the stent ‘scraping’ across my eye ball. My eye still tears but I’m hoping that will cease once the stents are removed. Also I wasn’t given any drops on discharge. The stitches from the wound site are visible I managed to pull 1 out, I would have thought they would have dissolved by now. My follow up is 9th Oct. Any advice or remarks please. Also I need the op on the left eye.
Ps no bruising whatsoever.
Many thanks.
Soniasonia
Thanks for writing. The tubing you feel in your right eye when you look sideways is normal. Unfortunately you’ll have to endure that until it’s removed. The tearing continues because the tubing is ‘blocking’ where it should drain, so when the tubing is removed, the tearing should cease.
It sounds like you’ve had an external DCR since you mention stitches and they sometimes need a helping hand to be pulled out. You definitely should have received drops such as Chlorsig ointment to prevent infection and reduce itching and irritation. Go to your local doctor and demand the correct drops (or directly ask for Chlorsig ointment).
I’m glad there has been no complications, let’s hope that continues. Please keep us informed of your progress.
Hi my mother had a DVD on August 24th she was fine up until late 2 days ago. Now she is saying the light hurts her eyes. It explained it like shooting pain and contracting. I’m not sure what to do if I should take her to the hospital or not. We called the dr office they said to wear the sunglasses she was given, which is fine during the day but at night what is she to do… she does have the tubes but I never noticed them in the corner of her eyes. I’m really nervous.
Dear Sheena,
Your mother had a DCR? Such a procedure can indeed cause sensitivity to light and most doctors will see it as a very minor issue and send you home. But they should investigate further, don’t you agree? Is the light sensitivity on both eyes or just the eye she had the DCR on?
I can understand you being nervous and worries, she’s your mother and you want the best for her. I’d suggest you take her to hospital even just for your own peace of mind. These issues should never be taken lightly especially in older people.
I’m thinking of you and your mother! Please let us all know how she goes and best of luck Sheena.
She had the DCR in both eyes and she says it’s mostly her right eye but when she opens he left the pain on there to and goes to the other eye.
Sounds like she had DCR recently. Surgeons often downplay DCR and call it a minor surgery but when you drill through bone and massacre the tear sac I’d hardly call it ‘minor’. You can see youtube videos of the surgery performed and it may send shivers down your spine. For this reason it’s a surgery I’d class as serious and not enough post-operative care is given.
The eyes are linked with nerves, if you have one problem with one eye, often, the other eye will feel it too. DCR does tend to aggravate the nervous around the eyes. This could be part of the reason for the light sensitivity.
On the bright side, the body is an amazing self healing organism and your mother’s body is now beginning to slowly heal. These worrying side effects will occur, but please see them as temporary for now and they will totally clear up with time. If they don’t please do seek further medical opinion ‘if’ you can find a compassionate surgeon to investigate properly.
Please keep writing to us with any concern at all. Let us know how she’s progressing and keep us informed.
I am going to a pre op appointment next Thursday and I am realy afraid of the possible complications of this surgery DCR possibly under local. I plan to ask about complications but to be honest I am so afraid of the surgery that I will almost certainly back out. My R eye has run on and off for years but has cleared up on it’s own for a couple of years but back now since last November running and had a couple of infections that have cleared quickly with treatment. Am afraid of making wrong choice. Will ask about probing. Is there an adverse effect of not having the surgery to correct it.
It seems really scary the things that could go wrong and would hate to be worse off after surgery. The running is a slight nuisance that apart from the occasional infection I am living with it quite well.
Hi Diane, I’m glad you found this website before having DCR. You’re in a better position now to make an informed decision.
The only consequence of not having DCR are the infections. However, if they’ve been clearing up well and you have intermittent reprieve from watering then you could simply live with it. It’s still your decision and you need to weight the risk to benefit ratio. Good luck!
Thank you for that. To be honest I doubt that I will go ahead but will still go and have the appointment and talk to them and ask if probing could be done, It’s a different surgeon this time but the lady I saw before said no when I asked if anything else could be done other than the DCR.
Most of them will refuse to use ‘Probing’ because they believe it doesn’t work. I disagree, especially those with only a partial blockage. What I’d recommend for you is to ask to have an X-ray of the blockage, specifically a Macrodacrocystagram. If it’s only a ‘partial’ blockage then I’d be more firm with them upon requesting they probe the blockage.
Regardless, there is no reason why they cannot use ‘probing’. Since you often go into remission with the tearing, it maybe just the edge you need.
Be firm and demand a Probing be conducted, or go elsewhere for it. Good luck!
Thank you very much for that. I will be asking about the X ray and the probing. Been good to get this info. I was really feeling that I’m just being a scaredy cat but I feel now that my concerns are warranted.
Hello,
My 2 &1/2 years old daughter is about to go lacrimal surgery this Friday. I am still concern of this surgery that am i making correct decision for her going through the general anesthesia? what are side effects of this? how soon she will be heal? Should i back out ? she does gets tear almost everyday that does not pass through her tear duct. However, since we knew we haven’t had much massage her lacrimal to opened it. Should i wait for her to grow or is this a right age to do this surgery….our doctor said they will use tube and balloon both…
thank you in advance
Bavin
Hi Bavin, They usually don’t do DCR surgery on babies and young children such as yours. If they mentioned they will use a balloon and a tube, it’s likely not going to be a DCR. But ask them directly if they plan on performing a DCR that involves drilling a whole in the nasal bone.
I think that is correct, its not DCR, they told us its lacrimal procedure, doing a balloon and tube. How risky this procedure is? should be safe to do for this young child? should i wait little longer?
what after care should i be doing if we go for it?
Thanks for your quick reply.
Best
Bavin
Hi George,
So I sent this e mail to my MD and got a bogus response. Seems like he downplays it.
My e mail: Hi Dr. Leibowitz,
I had DCR by you and Dr. Liu on my left eye 9/2/16. I’ve been having some side effects post surgery on my Left eye since. At my 9/7/16 post op appointment, I indicated to you that I still teared. However the side effects I’ve experienced since include more than just tearing.
The tubing came out. Since 10/5/16, I have been having intermittent sharp pains with a prickly sensation on the bottom of my eye when I close it. I’ve been experiencing some eyelid twitching.
My eye waters worse than before my surgery. There is foul smelling and dark colored mucous/tissue that comes out of my left nare which has been stuffy.
After doing some research, I might have “sump syndrome.” Whenever I blow my nose even gently, air and sometimes mucous comes up my eye through the bottom puncta. Will any of the above mentioned subside? I’d like to know what my options are because this is bothersome? Thanks.
His Response:
There is a lot to discuss below and probably better if you make an appointment for the office.
I’ll try to answer the questions. Firstly, there isn’t anything about a sump syndrome in the tearing system. That refers to a problem with GI surgery. Secondly, the pain, prickly sensations and twitching also probably have nothing to do with the DCR surgery. What is relevant is continued tearing. DCR surgery is only 85% successful, which is the figure when the tube is kept in for 3 months. Since you pulled out the tube early, the success rate is lower, although we don’t have a quantitative number for that. I need to do another irrigation in the office to see if the tear duct is still open. When I saw you in the office, you told me that the tearing was improved.
From the sound of things, it seems that your tear duct is still open. Otherwise, you wouldn’t have any discharge coming out of your eye when you blow your nose. This indicates that the pathway is still open, which is good. Sometimes people get mucous from having a dry eye, which is now dryer since the tear duct is open. It sure is dry in Bakersfield. I would use artificial tears four times a day and see if that improves things. Please feel free to make an appointment for the office, so I can examine rather than theorize.
And I never told him the tearing was improved. When I saw him I said it was the same.
Hi Lorie, I concur that your surgeon seems to have downplayed your symptoms. The pain, prickly sensations and twitching are certainly all sensations I also experienced after DCR and I’ve received many emails from others post DCR with similar symptoms.
On the other hand, your surgeon is correct when he says that the success rate of DCR is dramatically reduced when the tubing is pulled out shortly after surgery. The tubing should remain for several weeks to prevent the hole from scarring over. However, Dr. Leibowitz seems to think the hole is still patent and open due to the fact you are experiencing the air regurgitation through the lower puncta.
Dr. Leibowitz may also be suggesting your eye is ‘dry’ rather than ‘watery’ and thus has recommended the use of lubricating eyedrops. There might be some truth in that because the hole produced by DCR is larger in diameter (usually 7-12mm) than the natural nasolacrimal duct so MORE tears are rapidly drained, thus drying the eye.
I recommend you go back for a follow up as Dr. Leibowitz is suggesting.
I believe those symptoms will eventually go away. Time heals and DCR is a rather invasive surgery. Clearly, we need a whole new approach to treating epiphora and that’s by lesser invasive techniques that open the natural tear duct.
Hi,
George Sir
I had External DCR in my left eye on June 6,2015 and my right eye is good and working properly,there is no teras blockage problem. Before Surgery, my left eye teared out from last one year, I consulted with Dr. and taken antibiotics and medicine contineously. After DCR, tears stoped and my left eye started working properly. But after 6 months it started again. I again consulted with my Dr.. He said your DCR operation failed and your surgery will perform again.Now, I don’t want surgery again and I can’t cope up with it any longer, my eye stay so irritated and row from from wiping tearing.
So, Sir please provide me some solution about my problm, what should i do. Should i have surgery again? Because Dr. said , there is only 80% successful cases in DCR surgery. I am very scare.
Hi Shikka, thanks for writing to us. External DCR should have a higher success rate than 80%. What country are you in? Do you have a choice of seeing a different surgeon? I’d be hesitant about consulting further with the same surgeon.
Did you have the tubing in place for a few weeks after the surgery? We’ve had a few people write to us about how their tubing came out not long after surgery. If tubing is not left in place, the new hole created by DCR will scar over and not drain your tears out.
Hi George
I am a 75 year old male in the UK and have found your Blog whilst researching DCR following a visit to a Consultant at our local hospital. Tests were done and it was established that my right drainage gland was totally blocked and the left only 25% effective. DCR Was therefore recommended by the Consultant and normal side effects explained.
Having had a couple of days to think about it and do some research l am seriously questioning whether this is something that l want to embark upon. Without being overly pessimistic, l am heading towards my possible ‘sell by date’ and have other chronic physical problems, albeit none of them life threatening.
My wife and I had to cancel a special holiday last year for health reasons but plan to do it this year. The watering eyes are a nuisance but don’t stop me from doing anything and l am reluctant to do anything that could create any additional issues. I would appreciate your thoughts- are there any particular consequences of leaving things as they are? I wear glasses and l noted the problem encountered by one-off your correspondents, don’t like the Idea of fluttering either. I have played a lot of contact sport in the past but have probably only had about six nosebleeds in my life. The Consultant suggested that more frequent bleeds would be likely. Any comments would be welcome. Regards
I had a revision right DCR (both were external) 4 weeks ago. The first time was a total failure and my tearing never got better. On the revision, after about a week, there was improvement with the tearing and then all of a sudden in the 4th week, the tearing came back. The stent is still in place. Should I be worried?
Charles usually when a DCR fails, and the stent remained in place it means you’ve scarred over the DCR hole excessively and it blocked again. On this second DCR, the tearing can be normal with the stent in place. The stent acts like a type of ‘punctal plug’ used to treat people with ‘dry eyes’. The stent blocks the tears from draining into your nose. It has no where else to go and thus, it drips down your cheek. So…
…it seems like the DCR hasn’t worked, but the tearing is caused by a different issue. When the stent is removed, in theory, the tears should drain through the punctum again.
Be patient and please try not to worry too much about it. We’d all be interested to know how you go after stent removal please provide an update.
How long should a stent be in? My husband had the first surgery and was told they remove it in 12 months. Soon after that first surgery the tubing came out of his eye in a large loop. He called the Dr. Office an another doctor told my husband he needed to have a second surgery to replace the last tubing and that he ties it differently. That second surgery was a year ago in Dec. We were looking forward to having my husbands tubing finally removed but the Dr. Said my husband had an infection, gave him antibiotics to clear it up before removal. Next visit a couple of weeks later the dr. Told him some people choose to never remove the tubing. I was upset that my husband didn’t have it removed that day. The worst part of this story is that my husband accidentally pulled it too hard while blowing his nose and the tubing snapped back. The doctor cut part of the tubing from his nose and cannot find the knot and my husband is going back into surgery for the third time for stent replacement. I think they should only remove the remaining knotted tubing and never replace it again. What do you think? By the way the Doctors are 71+ years old. Also, all the steroids have been making his eyes react so strangely. I am worried about my 61 yr. old husband.
Hi Cindy, the tubing should only remain post DCR for 6 weeks. I’m surprised they’ve left it in there for an entire 12 months! That’s 12 months of discomfort. Unacceptable!
So if the tubing snapped when your husband blew his nose, that’s probably a good thing! He finally got rid of it. You can remove it yourself, just tug it out via the nostril if the surgeon refuses to remove it.
Help! I had a DCR two weeks back as of tomorrow. I’ve been too the er once and they just made me an appt due to eyelid swelling, but here I am two days before my appointment and I can no longer see the tube up my nose, which doesn’t cause concern except for the fact that entire left side of my face is extremely swollen. I look like 2 face. One side is normal but the other is puffed up. I feel like there’s fluid in my ear there’s tears coming out of my nose, and when I suction my nose there is yellow mucus, which could just be normal but nothing on the right side which brings me to believe that it might be caused by the DCR. Has anyone ever heard of the tube getting loose and moving somewhere else ?or tears feeling someone’s face because it’s very very swollen my head hurts constantly and I can’t get it to go away even with pain medication.
Take note here readers!…Read Ambers description…and please don’t suggest DCR is just a routine surgery. It CAN go run and it DOES go wrong. So heed my warning…try the conservative approaches first!!
Okay Amber…based upon your description and the yellow mucus you could possibly have an infection. Pain meds won’t help if it’s an infection and you need to be assessed correctly.
Yes indeed, the tubing can loosen, dislodge and migrate elsewhere. It’s happened to many people whom have posted here. Can you still feel the tubing on the inner corner of your eye? The only repercussion of the this is that the DCR hole may scar over and not remain open. So the surgery may be a failure.
Good luck and keep us informed of your progress!
My son was born with blocked tear duct on his right eye, with constant purulent discharge. Massage didn’t solve so he was submitted to probing under general anesthesia when he was 3. It didn’t solve it so he was submitted to endoscopic DCR a year ago, at the age of 4.
He still has the same problem, purulent discharge and has developed sinusitis after de DCR.
He has been for 3 months taking antihistaminic every day. The doctor says he is surprised with the outcome of the surgery which is usually very successfull. He said to wait until September to review and to keep the antihistaminic. Probably will need a second DCR.
I am very worried because I don’t want him to undergo another operation under general anesthesia, but I don’t know if there are alternatives, I think that the problem will not go away on its own.
I am also concerned about taking antihistaminic for such a long period at such a yoing age (he is 5 now).
I am taking him to another doctor ob friday to get a second opinion, but I feel like I am running out of options.
The constant yellowish discharge from his eye is probably not good, as it is an infection, I’m affraif it could infect other parts of his body.
The only times he has a clean eye is when he is under antibiotics for other reasons.
I feel completely lost because I cannot help my son get better.
Hi Joana, I see you’re in a difficult situation there. I would be very cautious of long term use of antihistamines and they can cause further problems!! Antihistamines are very drying and reduce tear secretion which can, dry the nasolacrimal duct and BLOCK THEM. Thus antihistamines can cause the very same problem you are trying to fix.
It’s a matter of finding a doctor to use an alternative such as “stenting”. Here is a video to illustrate: https://www.youtube.com/watch?v=sCLxfJL_n7w
It may require you to travel to find the correct ophthalmologist to treat your son. Best of luck!…
Hi George,
My son, who is now 6 years old underwent the second endonasal DCR on May 8th this year, followed with silicone intubation (right eye) which the doctor removed last Monday (September 3rd). However, he removed the tube only partially, through the eye (he pulled from the top and bottom punctum, the bottom one he pulled hard, it seamed he wanted to pull out the hole tube from there), and the end of the tube was still inside the nose because he could not reach it, it was in too deep – this was done with my son awake so it was difficult for him not to move, although he surprisingly kept quite still through the all procedure.
We were able to see the rest of the tube through the endoscopic camera, but the doctor tried and tried and could not grab the tube. My son was suffering with this so the doctor said he wouldn’t insist anymore that day and told us to come the next day. So on Tuesday (September 4th) we went again and the doctor examined with the endoscopic camera and the tube, which was seen inside the nose (deep in) the day before, was no longer visible.
The doctor said it could have descended through the nose and came out the nose, but I don’t think it is possible we would have missed that. He said he does not believe that the tube is still inside the nose or my son would have complained with foreign body sensation, but my son was with the tubes for 4 months and never complained, he did not feel it, would he feel this lost part of the tube now – is it different?
We are now scheduled to go there again on Monday (September 10th) to examine if everything is ok.
I am very concerned that the rest of the tube is still inside the nose, lodged somewhere. I read about a case of DCR in a child where the knot was retained inside the lacrimal sac after an attempt to remove the tube by pulling the tube out through the punctum, which caused the failure of the DCR and the need of a second surgery. I think that possibly the doctor was attempting to pull my son’s tube through the punctum too, as he pulled the bottom one real hard, and failed, and now the rest of the tube (the knot) is retained in the lacrimal sac.
Would much appreciate your thoughts and opinion on this and what should I do or ask the doctor to do.
Thank you for your help.
Kind Regards,
Joana
Hi Joanna…I missed your message sorry. Has it been resolved now or do you still believe their are remnants of the tube in your son’s lacrimal sac? I’ve heard many cases where one doctor could locate such tubing, whilst others couldn’t. On that basis, it’s always best to consult with someone different.
Hi George,
Thank you for your message. I don’t know if it is resolved. We have been to the doctor on September 10th and no sight of the remnants of the tube – the doctor examined through a camera inside the nose.
I asked him if it was possible that the rest of the tube was in the lacrimal sac and he said it is not possible because of the knot, it wouldn’t pass through the narrow passage from the nose to the lacrimal sac, and also if it was there it would be palpable and felt from the outside.
My son is scheduled to go there again next month to see if there are any developments. He has been fine, with no purulent discharge nor watery eye until now.
My concern is if the tube is still there could he develop some kind of infection, is it harmful? The doctor said that if the tube was still there he would have already had side effects, like secretion, possibly inflammation.
He is trying to avoid another general anesthesia to locate the remains of the tube, which he said that for sure came out the nose (I don’t believe it, I would have seen it) or were swallowed (this is more likely for me, I guess).
I’m not sure on consulting another doctor, as this one has really good reputation here and I am not sure what another doctor could do differently to find the tube without general anesthesia. But perhaps I should.
Thank you for “listening” and for your advice,
Joana
Hi Joana…the fact the surgeon has a good reputation doesn’t always necessarily mean they will go out of their way for you. The surgeon who did my DCR was highly recommended. But he was arrogant, closed minded and wasn’t willing to “probe” the block out. He firmly said DCR was the only way. Later, I discovered their were better surgeon’s than himself. In fact, an Australian man wrote to me about his surgeon actually buying new equipment so he can look even closer into his lacrimal duct. He discovered a tiny block that could easily be probed. It worked, and avoided DCR surgery whereas 99% of most other surgeon’s would have ushered him into DCR surgery.
So my advice would be to find someone else. You have nothing to lose but increased peace of mind, knowing if they can find some remnants of the tubing or not. If they can’t, then leave it be. If an infection occurs in the future, then certainly it may indicate there is something still there.
Let us know what you decide to do. I hope you can find peace of mind with a solution and move forward to a bright future. All the very best.
Hi
My mom had DCR surgery on both her eyes on June 22. There was a lot of bruising around her left eye and her eyes were tearing just as badly, if not worse, than before the surgery. We went in for the follow-up today, July 17. When the doctor was removing the tubes, the one from the left side was extremely painful and my mom was crying out “Why does it hurt my eye so much??” The doctor didn’t say anything other than “you have to help me here.” He then put a couple of numbing drops in her eye and used a metal device (I think he called it a lid scapula) to hold her eye open. I didn’t watch but my mom’s cries of pain told me how bad it was. My question is whether it’s normal for the tube removal to be so painful. It has been the worst part of the entire process. As well, I’m concerned the doctor was impatient and perhaps just yanked the tube out, damaging any potential channel that may have been healing. Also, her eyes looked like they were bleeding a bit and her tears were tinged with pink all evening. Again, is this normal and did anyone else experience this?
No it’s absolutely not normal to experience such pain during tube removal. I’m wondering if your mother may have had an infection?
There would not have been any damage done from having the tubes yanked out. The new tear channel formed from the DCR can’t be closed at all (in fact, it’s extremely difficult to close), so your mother shouldn’t be getting any tearing.
How does your mother seem not almost two weeks after surgery?
Hi, I am a healthy 70 yr old women, left eye started watery a lot about 4 weeks ago, hate it makeup want stay on. went to eye Dr today he put drops in, put on special glass’s and the stuck a needle in my tear duck that hurt but only lasted a few seconds then took a sringe of water and made my chair go back then put the water in the tear duck which came right out of my eye and down my face gave me Neo/poly/dex drops told to use for 5 days and if it did not clear up he would refer me to a a Doctor who would do surgery after reading all the reviews don’t think that will happen what else do you think i should try he said he thought it was to blocked for these drops to help, I live in Benton Arkansas 20 mins from Little Rock and the great Univ of AR medical center which has a great eye clinic, love my Dr and he takes great care of my eyes, i am very social and out a lot so need my eye makeup i look like i am crying please help. Thank you Stacy
Hi Stacy, Sorry to hear the diagnosis of a blocked tear duct. Your doctor is correct, the drops are not likely to remove the block at all. But you can give it a try and see what happens!
I’d caution you against DCR…that’s what this site is about! Too many surgeons are quick to throw you into a surgery they deem “minor”, but in reality, when they cut a hole through your bone and permanently alter your nasal system where you breathe onto your eyeball…it’s hardly “minor” is it? What’s worse is that you may only have a partial blockage and they rarely recommend you to have a macrodacrocystogram done to locate precisely where the blockage is. That’s nothing less than medical malpractice!
I’d demand from your surgeon the less invasive procedures. Please browse through my website and you’ll learn about balloon dilatation and stenting. Just be aware the eye surgeons often tell you they don’t work. Well, they are WRONG…they DO work, just not to the same percentage of DCR. I’d rather take my chances with the less invasive procedures first, wouldn’t you?
If your surgeon refuses, find another one! There will be someone out there willing to be flexible for you. Afterall, it’s YOUR body.
Thank you so much, i will ask about all the none invasive things first as much as i hate the tearing i don’t want a DCR I will let you know after my first appt with the surgeon.
Hi George, my uncle is 65yr old, he had cataract surgery done on left eye in 2014. Recently, we went back to the same surgeon for right eye cataract, but was advised that his tear duct is blocked which is normal at his age but suggested removal of a sac(I think that is lacrimal sac) if not treated than it might get infected after cataract surgery when steroids are applied so we went ahead with the minor surgery but after 2 days we noticed small bubble in his eyes n his right side face has swollen up. Contacted the doctor but he suggested it to be normal. Please advice whether these signs are normal or any infection sign. Thank you Dawa
Hi Dawa, thanks for writing. I’d suggest you go and see your eye surgeon again. Your description of “small bubble in his eyes” is not something I can visualize. The right side of his face may swell up slightly, but if any of these signs are present you need to return to your eye surgeon.
Best of luck and I wish your uncle a speedy recovery!
Hi, I had a DCR procedure done on my eye about a year ago, and everything went very well. The tearing in my eye was gone. This was a year ago. Suddenly about 2 weeks ago, I started waking up with sleep in my eye and excessive tearing all throughout the day in this eye and I thought I had a cold in my eye where maybe the tissue in my drainage duct had swelled up a bit causing the tearing. The tubing is still there in the corner of my eye in the 2 holes (it hasn’t moved) and tied inside my nose. So as far as I can see it hasn’t moved but I could be wrong (like I said it’s still in the 2 holes and tied). But it’s now 2 weeks later it’s tearing more than before I had the surgery and I don’t think I have a cold in my eye. I still have sleep in my eye when waking up. There is no redness or pain or bumps. I am contacting the eye surgeon/doctor to notify them and probably have it taken out. I am wondering if this tearing is normal after a year of no tearing after the DCR procedure.
So you had a DCR 12 months ago an still have the tubing in your eye? Oh no, you should have had that removed a few weeks after surgery. If would be blocking the tears from being drained into your nose. Please do see your surgeon and have it removed.
Hi all,,I had internal DCR 29th Jan 2018 its one week on and the pain at the top of my nose is so bad 🙁
it is the area where they remove the bone,,i am taking loads of pain killers and nothing seems to touch the pain,,i have noticed it get really bad when its cold and on a evening.
This pain only started 3 days ago and i am unsure to go see a doctor as i dont know if its normal
Im glad i come across this site wish i had looked before i had the op done in honesty i wouldnt have gone ahead with it!
DCR is a awful operation was meant to be getting my second eye done but that will never happen!
Thank you for reading x
Hi Donna,
Thankyou for contacting us. How is the pain going now? It seems strange to have pain from DCR to that degree just few days after surgery. Yes they cut the bone out to get to the tear duct. Did they explain that to you before the surgery? My surgeon didn’t. In fact, one eye surgeon told me he deliberately skips that part because it frightens his patients. They refer to it as a ‘minor procedure’.
If the pain is still present, please return to the surgeon who did it and notify him/her. Please let us know if you discover anything. We can all learn from this.
Hi George,,
Thank you for your reply yes the pain has now eased thankfully 🙂
i still have a black eye and trying to adjust to the feeling of having a tube over the eyeball lol
Yes the surgeon told me they take a “tiny” bit of bone out the nose!
i have since learned its alot bigger than “tiny”
and i was told it was a “minor” operation which i feel is a total lie !
I would never ever get that surgery done again and regret having it done now 🙁
Im happy im finally recovering from it tho still getting headaches but the worst is over i hope
hope you have a lovey day
again thankyou for your reply x
Hi George
I find your blog very interesting. I had a DCR performed on both eyes in November 2017 and more than 3 months on I still have excessive tearing and a slight headache at the bridge of the nose. Apparently the tear ducts were patent beforehand but when I first noticed it several years ago the left one was not patent. I use a microwavable hot compress which helps a bit and false tears.
Is there anything else – non invasive I could try to cure this? It is very awkward having tears pouring down my cheeks all the time. The surgeon said I may need a Jones tube inserted – what do you think of this? I am reluctant to have any more potentially failed surgery. Thanks for your help.
HI Cathy…I must have missed your last post. But I’m here now 🙂
I understand you have had the bi-canicular tubing removed? That’s the tubing they keep in your nose for up to 6 weeks after surgery. Usually, when that’s finally removed the excessive tears clear up because it acted like a temporary ‘Punctul plug’. However, if it’s been removed and you’re still tearing, then there’s a problem.
It means you healed faster and your body has scarred, and closed the ‘drainage hole’ they created. Your surgeon would assess that by going in with an endoscopy. He or she would then recommend a ‘second’ DCR. I’ve certainly known people to have a ‘second’ DCR due to a failed first attempt…and it was successful.
If your surgeon suggested a Lester-jones tubing then he’s also suggesting you have a ‘further’ blockage higher up. A Lester-jones tube comes with it’s own complications, especially with clogging up and not remaining patent.
So it depends on where the block is… Nasolacrimal duct or with the Canalicular.
The only alternatives you have is to insist on a “probing” of the blockage. I’d also want a clearer picture of what’s going on. Have you had an x-ray of your ‘tear drainage passage’ to determine exactly where the blockage is?
I wish I had more options for you but this case has more question marks.
Hi George
Not sure if my last message got sent…….I find your blog very interesting. I had a DCR performed on both eyes in November 2017 and more than 3 months on I still have excessive tearing and a slight headache at the bridge of the nose. Apparently the tear ducts were patent beforehand but when I first noticed it several years ago the left one was not patent. I use a microwavable hot compress which helps a bit and false tears.
Is there anything else – non invasive I could try to cure this? It is very awkward having tears pouring down my cheeks all the time. The surgeon said I may need a Jones tube inserted – what do you think of this? I am reluctant to have any more potentially failed surgery. Thanks for your help.
Hi George
Thanks very much for your reply.
Yes the temporary silicone tubes came out after about 1 month. so it’s now been about 2 months + and if anything the tearing is worse than before. Will the second DCR be as traumatic as the first? I bore it but wouldn’t want to repeat unless absolutely necessary! Presumably as the hole is already made it won’t be as bad? What do they do?
Yes, they did do an xray (with dyes) a couple of years ago and it was partially blocked but no repeat nearer to the surgery.
Do you think balloon dilation is a possibility for me?
Thanks, this correspondence is very useful.
Cathy
Hi George
Thanks again for your advice. I saw the registrar yesterday and I am going to have a repeat of the special xray with dye to ascertain where the block is. he said it would most likely show that I would need a Jones tube inserted. Having looked this up, I am rather reluctant to have this – is it really mad of glass?!
If he suggests another DCR would this mean an op exactly like the 1st one – new hole formed etc?
He said probing was just for children an wouldn’t hear of any discussion about this.
Any further advice would be much appreciated.
Thanks again
Cathy
Hi Cathy, good to hear from you.
Personally, if it were myself I’d see someone else if he refused to probe for you. A surgeon needs to take our ‘feelings’ into account and if we don’t want surgery they should cater to that. However, you may not be in a situation to see someone else?
Go ahead with the x-ray. At least you’ll know where the blockage is. Yes the Lester-jones tube is made from glass and there’s a reason for that, read about it here: http://www.lesterjonestube.com/
There have been a few people comment here that their Lester-jones tube has become blocked. Apparently, since it’s so thin, it’s liable to blocking and is a common problem. I believe they can easily syringe it clean again. Otherwise it works very well.
If you have to have the DCR again, they don’t create a new hole. The hole they made through the bone is still there. It’s just been blocked by scar tissue. The bone itself doesn’t close. So in terms of a second DCR they simply press through the scar tissue and it’s a relatively quicker procedure since the ground work has already been done previously. There’s a higher success rate that it will remain patent after a second procedure. I’d personally suggest having a second DCR since they’ve already drilled a hole through the bone, why not just have a second try?
Keep us informed with what they discover Cathy. I wish you the very best.
I had an external DCR done on my right eye in December 2017. A stent was placed in my lacrimal duct and under my nose. I had nose bleed a few hours after I was discharged from the hospital but I was informed it is normal as long as it is not severe bleeding. As in any external DCR, my eye and cheek area where the suregry was done was so swollen.it was like that for about 10 days. I was advised not to blow or pick my nose until the stent is removed. if I sneeze, I have to close my eye tightly so as not to let loose of the stent. I followed diligently all these advice. I was on antibiotics coupled with topical antibiotic which I apply on the incision site for10 days. After the surgey I noticed that there is a bump near the incision site. The size is of a pumpkin seed but elongated. I did not bother asking the opthalmologist what was it and why was it there because I thought it will come off once the swelling is gone. Note that my tearing did not resolve after the surgery. It was even worse. After 6 days, I went back to the opthalmologist to have my stitches/sutures removed. After 2 weeks, I had infection (my nose bridge and the part of my face just below my right lower eyelid were swollen) so I was prescribed another dose of antibiotics for 10 days. The tearing still did not resolve and the stent strated to irritate my eye so much so that I feel very very uncomfortable I was tempted to take it out, but didn’t. On the 6th week I had an eye infection. I went to a walk in clinic because my opthalmologist was away on vacation. The walk-in clinic doctor said he doesn’t know what the opthalmologist did but he thinks it’s a pink eye and he prescribed antibiotics (eyedrops) for yet another 7 days. The stent was finally removed on February 14th which is after 2 months. My excessive tearing has stopped when the stent was removed. I still have tearing specially on windy days and when my eyes are tired but I consider it normal. The incision site has healed too however the bump that was there after surgey did not go away. It’s very visible and painful when pressed. I don’t have keloids if this is considered a scar. The reason I know I don’t have keloids is when I had laparoscopic surgery no keloids had developed in any of the 4 surgical sites. All my wounds had healed well, no bumps, no keloids. My doctor said the bump is from the surgery and advised me to massage it with Vitamin E 2-3x a day. The bump is hard inside and feels like a bone has regrown. Has anyone there have a similar case as mine? What did you do? Did the bump come off after sometime? How long? If it did not, what can be done? My next check up is May 2018. I hope the tearing will further improve as the months go by. My friend who had also a DCR said her tearing had improved a lot. She is on her 15th year now with no issues at all. She has no scar as well on the incision site and no bump. I’m bothered with my bump not for aesthetic reasons but more because my eyeglasses can’t rest well on my nose bridge because of the bump. I still have slight swelling in the corner of my eye and lower eyelid and the shape of my right eye does not look normal yet but I am optimistic everything will heal in due time. I agree that any surgery alters our body’s normal structure and have negative consequences. The good thing that happened to me is I went home after the surgery without a third eye. if I did, I would go crazy. My eyes are intact and I could still read. Your comments about the bump near my nose bridge and incision site will be highly appreciated.
Hi Susan, thanks for writing. It would have been more advisable to have an “Internal DCR” performed and there is never complications on the nose regarding lumpy formations.
The lumpy formation will not diminish over time. It’s their to stay and since it’s causing issues with your glasses and just knowing it’s there is a real nuisance. The surgeons will have you believe it’s an ‘insignificant’ consequence of external DCR, but they don’t have to live with it! Indeed, the reality is that it’s NOT insignificant and they should be taking measures to amend the problem. Sadly, they won’t.
If I was in your situation I’d see a talented cosmetic surgeon. They work with diminishing such issues and will completely remove the lump for you. Yes, it’s a shame you have to treat a ‘side effect’ with yet another surgical intervention. It’s rather insane!
Being left with a lump on the surgical site of an external DCR is an extremely common side effect. Were you warned of such a consequence? Regardless, it’s done now and you have to resolve it. Let us know what you decide to do and we’ll all be interested to know how you resolve this problem.
Thank you so much George for your reply. The lump has subsided just a little bit but I think it’s going to stay there forever. My friends noticed it’s not that too raised and bumpy compared the last time but it’s still very visible even from a distance. It’s sad that I have developed this scar or bump after my external DCR. I will let you know (and everyone) my next steps. I should have read the articles published in this section and posts from patients prior to deciding on having an external DCR.
Help!!! had my DCR jan 29th 2018
a few weeks back i got a lump(like a huge spot) in the corner of the eye i had my operation,,,(in the inner towards my nose )
Anyway i got antibiotics to put on a few times daily
since then i got flu and ive sneezed and sneezed I have now sneezed out my tube via my eye!!!
ive tried to pull it out as gentle as possible but it hurt like hell,,,,
cos i had a big loop in front of my eye i cut it cos i couldnt stand the pain
will it come out (the rest that is left in) or do i need to see someone ???
thank you for your replies in advance x
Tape the tube to the side of your nose and call the doctor ASAP. Don’t pull one it. You may need to go to the ER to get it examined and how to treat while you’re sick.
Hi Donna,
I agree with Fran’s suggest. You need to see your surgeon ASAP. If you’re certain part of the tubing is still in your nose and won’t come out then you need it removed and replaced. However, since you had your surgery on 29th January it’s almost 6 weeks! Many surgeons remove the tubing after 6 weeks so I’d assume it’s done it’s job of keeping the new artificial tear duct patent.
Let us know what your surgeon does and if he’s placed a new tubing in for you. All very best of luck!
Thank you for your replys guys
When i cut the tubing i cut it as close as possible to the top duct then the bottom duct
im pretty sure the following day i could feel the rest of a tube in my throat so im hoping i have swallowed it !
I have not sought medical advice and seem fine so far
I panicked a bit i think and have made the wrong choice 🙁
I had my external DCR on Thursday, March 8th. It went longer than expected because I gave my permission to take pictures/film the surgery for training purposes. Otherwise, i think it went okay. I got some mild pain medication after surgery because I was aching a bit. After that, I really didn’t have any aches or pain. Just discomfort from the bloody discharge after surgery. I was prescribed eye drops and ointment for post surgery that I was able to pick up a couple of days before surgery. The hospital gave me a ‘moustache’ dressing to hold the gauze in place to correct the discharge from my nose. All the medicine is to help prevent infection. He did a nice job on the stitching.
Day 2 after surgery, there was definite improvement with the bloody discharge. It was not as severe and blood clots had almost stopped.
By Day 3, the bloody discharge completely stopped. Just an occasional tinge of blood with a primarily watery discharge.
Day 4, much improved. I do continue to get watery discharge. A couple of times my sinus ‘welled’ up. I put my head forward and down toward my knees to encourage flow. VERY GENTLY I blow to move the discharge forward. The other side is easier to clear out.
I try to sleep in a reclining chair with a neck pillow and my head tilted to the right (my left eye was worked on) to encourage sinus drainage to the side that wasn’t worked on.
Occasionally, I can feel the tubing in the corner of my eye, depending on eye movement and tugging the outer bottom lid to put in the eye drops. It’s annoying and I can hardly wait for the day when the stents come out.
Before surgery I had multiple trips to Urgent Care and a couple to the ER when the infection started swelling up the whole side of my face and risked more serious damage. The last ER trip they put a dye in me and did a CT Scan. There was definite blockage found.
The doctor who performed my surgery did beautiful work. I’ve no doubt everything will heal nicely and I’ll be rid of fearing future infections that could potentially get to my brain. I’ll come back with my progress.
Thank you for all your information about the surgery. I go to have my DCR done in the early morning and I’m extremely worried, rather hesitant if I may say so. They will be making an incision between the left eye and nose. Is there anything I should do or ask or request even before the procedure?
Hi Timeka – How did your DCR surgery go?
I had DCR surgery on the left eye a couple weeks ago. I went through a hospitalization on IV antibiotics before the surgery. So far it is a great relief to have had the surgery done. Nothing could get my infection to go away, it would always come back when I went off the antibiotics. Finally, I have some relief. I needed the surgery. It is a little weird when I blow my nose. I have to hold my tissue to the corner of my eye to prevent air from blowing on the eye, but this is easy to learn. I went for about ten years with a tearing eye, the infection was what made me get the surgery.
Hi! I am scheduled for a consult with a surgeon as I am told by my eye doctor that I need a DCR. It seems both tear ducts are blocked and I am very uncomfortable with tearing and crusting and it is affecting the skin around my eyes as well as swelling. My eyes always feel tired and sore. It started back in September of 2017 and progressed. When I went to the eye doctor, he gave me prescription for ointment to use with hot compresses three times a day. I did as instructed. He believed I had an allergy. Within a week went back to the doctor and he then gave me another medication ointment to use called Lotomax. After a bit that did seem to help and so I thought I was on my way to recovery. Then, within a couple of weeks it returned. I waited to see if it would get better and continue to use the medication prescribed, but after a couple of weeks or so more, I decided to see the eye doctor again. Then I started to get better and so I cancelled the appointment. Eventually, it just kept on coming back and getting worse. I finally went back to the eye doctor and he tried to flush my eyes with a syringe to no avail. That is when he prescribed me another medication of eye drops to use twice a day and to see a surgeon for consult on having a DCR. I am so grateful that this site exists and that I came across it, as reading all of these posts from others going through the same thing and the Insight on the surgery itself is a godsend. I am not sure exactly what I’m going to do but I have more questions than I would have and have a better idea of what the answers should be. I will Gauge by what I have learned here and hope for the best. Thank you to everyone who had post their experience on this site and for all the answers and feedback as well! Good luck to all of us!!!☺
Hi, I had a DCR on my right eye on 24 July 2018. Since then I regularly experience a strange smell but I can’t work out what it is. It’s not a bad smell but I can’t help think that it’s scar tissue or mucus or blood inside the noise? I do have the silicon tubing in place but I doubt it’s the tubing smell. I wonder whether anybody else has experienced this? Also more importantly, quite recently the vision in my right eye has gotten worse. My vision wasn’t 20/20 at the start but now it’s much more blurry and I can’t think that it’s anything but an impact from the DCR. I’m hoping that perhaps it’s some underlying swelling that impacted the eye and it will resolve but again, very strange for this to occur and it looks like nobody else has experienced this.
Hi Geoff, I’d recommend you have another consultation to check if there’s any infection. Are you on antibiotics (internally/externally)? I’ve had many people write to me about blurry vision after DCR. Usually, it’s only temporary and is definitely a result of inflammation. It should pass.
Thanks for your quick response and I’m comforted somewhat by your comment about the vision problem being temporary. I’m not on any antibiotics and only recently stopped using the eye drops and cream to apply to the scarring as prescribed by the Ophthalmologist. Thanks again.
Hi George
I had a double DCR about 11.5 months ago. It doesn’t seem to have worked really and I still have intermittent pain/ache at the bridge of my nose and both my eyes still tearing. Some days worse than others. About the same as it was pre DCR. I understand that balloon dilatation is making a come back and although I don’t think my consultant does it, I was wondering if it was worth trying this treatment with another doctor? or would it not work because I have had a DCR. Is it a painful procedure. I don’t want anything like a DCR again!
Because it’s UK NHS I see different doctors every time I go to the clinic and each one has different ideas each time. The last one agreed that there was narrowing of the new tubes post DCR perhaps due to scar tissue but didn’t have any answers. Rather frustrating after all I’ve been through.
Thanks very much for your advice.
Cathy
HI Cathy… sorry for the delay in reply. I get notified via my emails when there’s a new comment for me and sometimes miss.
Did you have an external or internal DCR? Having a double DCR is rather common, and so is having tearing again after surgery! DCR is definitely not a guarantee and that’s why they should use the less invasive techniques first rather than going in for the most invasive. Most eye surgeons want to use DCR, but a few are more conservative and even open minded to try the alternative solutions I talk about in this website.
Yes indeed, you can still have the balloon dilatation procedure after a DCR surgery. When they do the DCR, they create a new, artificial tear duct for the tears to drain into the nose. So they by-pass the blocked naso-lacrimal duct…it’s sort of “by-pass surgery for the nose”. So the natural tear duct, where you have the block has not been tampered with by surgery…and that’s where the balloon will go and be dilated, in an attempt to push the block back.
If DCR fails, most surgeons want to do it again. But if it continues failing, then they have no choice but to use balloon dilatation and stents. Chances are your body heals quickly, and it started closing the new opening created by DCR very quickly by forming scar tissue over it. I understand your reluctance to have another DCR on both eyes! I wouldn’t want too either under any circumstances.
The next problem you have is finding a doctor whom will perform the balloon dilatation! That’s been the main problem for a majority of people who write to me. They are always bullied into DCR and refused the alternative methods. My advice is to follow your gut feeling, which I can tell already you don’t want another DCR.
Gook luck, myself and other readers will be interested to know if you find someone for the dilatation. And we will be particularly interested to know how it goes for you. Please do let us know 🙂
Hi George
Do you have a moment to look at my comment about blocked tear ducts post surgery? I don’t think you’ve seen it yet?
Many thanks
Cathy
Sorry Cathy, please see response above 🙂
Hi George
Many thanks for your reply and advice. I had an external DCR about a year ago. The last doctor I saw hinted that I might need an internal DCR but also said another specialist does balloon dilatation. Trouble is no one has really said what the cause of my tearing is. I have to blow my nose a lot so perhaps it’s an allergy or is it just another form of dry eyes?
An internal DCR is presumably a lot less invasive? How does it compare with balloon dilatation in terms of recovery and unpleasantness?
A health shop has recommended Omega 7 so I’m about to try that.
Will keep you posted as to what I will do next. Thanks again.
Cathy it seems like you need to explore what’s causing the tearing.
# Is it just allergies? Do you normally get allergies with tearing?
# Is it due to the DCR opening being blocked by rapid healing and scar tissue?
# Is it dry eye because too much tears are being drained through the large DCR opening (that’s what happened to me).
An internal DCR is significantly less healing time than external DCR. Since you’ve already had the DCR opening created, having internal DCR would be a good choice. A second DCR usually has a good success rate. Or you may wish to try the balloon dilatation.
Further investigations are needed to determine what’s causing the tearing. Have they checked the DCR opening with an endoscope? I’d recommend you see an optometrist for a dry eye test and get a macrodacrocystogram done to determine where exactly was the block in the naso-lacrimal duct.
Omega 3 fish oils are usually recommended for dry eye conditions. The anti-inflammatory effect helps relieve dry eye symptoms such as tearing.
Hi, My consultant has told me following a failed DCR in November 2017 that I need Jones tubes inserted. I have excessive tearing from eyes and nose. Apparently I have “tortuous canaliculi which do not conduct tears well”. The jones tubes sound a bit alarming! Can you reassure me at all? and is it likely to cure the problem? Many thanks
Cathy
I have had a Jones tube in my left eye for 2 years. It is ok. Getting more tolerable, and I now forget it most of the time. Biggest thing I have experienced is having yuck come out the tube when I blow my nose.
Hi Carolyn, thanks for your helpful reply. Did the tubes feel uncomfortable when you first had them fitted? Has your tear problem stopped? I have a lot of blowing of my nose – does that mean that it would come out of the jones tube (at the opening onto the eye? Lots of questions – sorry! Not sure which is worse at the moment a prosthetic tube or constant tears!
It took a while to get used to, but not as bad as the tears running down my face. i have to take my glasses off to blow my nose, and use drops to keep open. The aggravation goes to my former eye doctor that insisted on putting punctal plugs in both eyes instead of just the one that needed it. Instead of falling out, as he had said, it fell in, and plugged the duct. My eye doctor then missed that, blaming it on the dryness of the other eye.
Hi Carolyn
Thanks again for your helpful response. My eyes have got slightly better since the DCR 18 months ago but most days still awful and tears stream down my face especially outside. I am seeing the specialist on Wednesday to discuss. Rather reluctant to go ahead with the tubes unless it’s the only answer! sorry to keep pestering you but did you have a DCR first? Are you in the UK? I wear contacts so I need to find out if they are compatible with the tubes. All the best with yours eyes and thanks again. Cathy
Hi Carolyn
Thanks again for your helpful response. My eyes have got slightly better since the DCR 18 months ago but most days still awful and tears stream down my face especially outside. I am seeing the specialist on Wednesday to discuss. Rather reluctant to go ahead with the tubes unless it’s the only answer! sorry to keep pestering you but did you have a DCR first? Are you in the UK? I wear contacts so I need to find out if they are compatible with the tubes. All the best with yours eyes and thanks again. Cathy
Hi. Carolyn/George
I have opted for the insertion of Jones tubes on 30 April both eyes. Rather nervous. Any tips on what to expect immediately after the operation would be gratefully received. Does it take a while to get used to them? Is it painful or just uncomfortable?
Many thanks for your advice.
Cathy
Hi Cathy….
Wow having both eyes done is a big step. I’ve only had DCR but not Lester Jones tubes inserted. The feedback I’ve had from others whom have had it done is it feels slightly “different” to begin with until they get accustomed to it…and then they don’t feel it anymore. I guess you’ll be aware that it’s there, and eventually you won’t notice it anymore.
The main problem with them is getting blocked. So ask your surgeon how to maintain them correctly to avoid blockages. Nevertheless it’s all very exciting and not very long to go now till the surgery. I will be thinking of you Cathy…I hope it all goes well and please let us all know how you’re doing..and keep us informed with your progress.
George.
Hello, I had excessive tearing on my right eye. My ophthalmologist probe tear duct 3 times and it was not successful. Still had several tears to the point my skin was raw, eyelashes were hardened from tears and several infections. So I saw my ophthalmologist and he told me the endoscopic DCR would work but he suggested I saw an ENT specialist. He did some tests
And realized I had blocked tear duct and there is some blockage in my nose. He told me to proceed with the Endoscope DCR procedure and my Ophthalmologist and the ENT doctor would perform it. I had it done March 3, 2020 and I had no tearing until I saw my ENT doctor 2 weeks after procedure for him to take some packing out of my nose. I sneezed several times as he was poking my nose to take the stuff out. So he said he that he took a lot out and the next visit we can proceed in taking more. After he took that out, I noticed excessive tearing on my right eye where I had the surgery and so much tearing on my left eye.
It is more tearing than usual on both eyes. Is this normal to have this much excessive tearing on the right eye where I had the surgery. I still see the stent on the corner of my eye. But the tearing is just way too much that I cannot see at times. I thought the tearing would stop but it has got worst. My eyelashes on the corner of my eye stick together and hardened and underneath my eye is raw from wiping. What should
I do or should I just wait to talk to both my doctors. My next appt is when the ENT and I have an appt on April 17th. Please help!
I’m so relieved to find this site with such helpful information. I had external DCR on my right eye due to excessive tearing 9 days ago. Prior to the surgery, 2 eye surgeons tried to flush my eye upper and lower tear ducts without success.
After the surgery, I could see the tubing in the corner of my eye where he threaded it thru the tear ducts. I had tubing with a large knot inside my nostril that was easily seen. The problem is the tubing that was in my nose is nowhere to be found. Luckily the tubing in my eye is still there. I called the surgeons office and the lady told me that this was normal with DCR surgery. Where did the tubing with the knot go? Should I be concerned? Thanks in advance for any advise.
It may have come out. Sometimes they do, perhaps go back for a check up. They need to remain in place for about 6 weeks to stop the wound from healing over.
HI, I had a DCR on Nov 4, 2020. I can’t say that I actually had a lot of tears before my surgery. I had this big bump on the side of my nose that got bigger and bigger and red from infection. I went through 3 rounds of antibiotics before surgery. Now after surgery and stent removal I get a lot of tears on windy days and my eye sometimes feels like it has thicker wetness. This week my eyes feel dry and hurt. Is this something that is normal?
I had a C-DCR two days ago. The tube feels like it’s scratching my eyeball when I look in different directions. Will this sensation stop? It hurts & causes double vision.
Lots of people experience irritation on the eyeball with DCR from the tubing. I experienced it and is did ease off but I still felt it. If it’s irritating you too much the surgeon can maybe do something about it. I’d go for a consult and tell him you cannot handle the scratching feeling and can he move it away from the eyeball. Afterall, he/she put it there so they are responsible for your comfort levels. It’s not appropriate to suffer for several weeks until they remove it.
I had a DCR about 12 weeks ago. I was not prepared for the pain and discomfort during the procedure and after. During the surgery I heard the surgeon say that the tear sac was completely shrivelled up. I had a lot of bleeding post op but was discharged after 20 minutes. I have had the tube removed. My main concerns are the blowing through the new opening when I blow my nose and the fact that I now have a mono lid on that eye. The surgeon has told me to use vitamin E cream but it cannot solve the problem of being joined incorrectly. Very disappointed and wish I was better informed…I would not recommend surgery.
Hi Astrid,
Sorry I missed you post and didn’t approve it till now. After all this time how are you going now with feeling the blowing on your eye? I found it disturbing and the surgeon didn’t tell me that was going to happen. I also found the eye looked different to the other eye, somehow the surgery distorts the shape of the eyelid.
I hope it resolved for you over time.
I had DCR in left eye 4 months ago. All went well and tubing is due out in January. No complaints …but I am a very healthy 70 year old Type 1 diabetic and am now experiencing pain in both wrists and ankles which has appeared very suddenly! Could a foreign object in my nose cause other complications in my body? My GP says t is osteo- arthritis but I am dubious. I went from No pain anywhere to instant acute pain in these areas.
Cheryl
Hi Cheryl,
It would seem unlikely the tubing would cause pain in your wrists and ankles despite it occurred when you got the tubing. There’s a slight possibility the tubing has caused an inflammatory reaction and has affected other areas of your body.
Let us know if the pain eases up for you. We’d also like to know how you get on after the tubing is removed. All the very best with it.
George.
So I’ve read most of the comments and mostly had complications. So here is mine. Had DCR August 3, 2022, just recently. Nov 14th, stent should come out. Previous months, I noticed that I have more tears flowing off my cheek compared before DCR. THought to myself, its normal because of the stent. So This week Nov.14 I went to the Dr, excited that the stent will finally remove. But oh no, it was blocked, so now I had to see the ENT doctor that did the nose part and see what’s going on. I am disapointed.
Hi Armie – you are correct with saying there is some tearing because of the stent. Yes the stent acts like a punctal plug and blocks the puncta so you would experience more tearing. But you’re very unlucky to have the puncta blocked after the stent removal. Have you seen the ENT yet?