My Story

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(See the Introduction from the homepage if you haven’t read it yet.)

The protocol for evaluating and treating epiphora in Australia is dangerously flawed. Let me prove it to you. In many cases when a patient is referred to an ophthalmologist/oculoplastic surgeon, they will have a syringe test performed. A syringe test works by injecting a saline solution into the tear sac through the puncta (the tear drainage holes) in the corners of your eyes. If you cannot feel any solution in your throat and if there is regurgitation of solution back out of the puncta in your eyelids, you are deemed to have a blockage. Then, in short order, you are recommended to have DCR surgery.

The above scenario is unfortunately common. There is no attempt at probing or examining exactly where the block is with a macro-dacryocystogram. Nor is there any mention of non-surgical interventions. It seems most surgeons using this approach argue there’s no use locating the block. They believe surgery is the only sensible solution. And on paper, DCR does look very good. It’s cost effective, it requires relatively few follow-up visits, it’s not extremely complicated, and it has a high ‘success’ rate. I put success in quotes there because I think that in the case of DCR, we have to re-examine our definition of success. Yes, there may not be a problem with watery eye anymore—but at what cost?

I also acknowledge there are brilliant and conservative ophthalmologist/oculoplastic surgeons who believe in surgery as the last resort. They meticulously examine the lacrimal system with probing, X-rays, etc., and first place the patient on the least invasive therapy, such as steroid/antibiotic drops. If those things fail, they’ll attempt other non-surgical approaches. Surgery is applied only as the very last resort and only when the patient is fully informed whether living with epiphora is better than possible complications of DCR. It is my honest, informed, and well-considered opinion that the practices of these responsible doctors should become the status quo.

My Epiphora Treatment & Complications

In the start of this ordeal, I had bothersome (though not unbearable) epiphora in my left eye. I would have a stray tear or two roll down my cheek at random points throughout the day. Although it wasn’t terrible, I know that these things can become out of control if not dealt with as soon as possible. So I went to visit my general practitioner, and was referred to an ophthalmologist.

At the ophthalmologist, I had both of my eyes syringed, and the doctor deemed them to have significant blockages in both eyes. I didn’t think he syringed them hard enough because there was not much pressure. Regardless, he immediately referred me to an oculoplastic surgeon, who had a three-month long waiting list. I had to move interstate during this time, and decided to let my watery eye be for a while to see if there would be any improvement with time. While I usually trust my doctors, I wasn’t feeling confident in my first ophthalmologist’s assessment. My right eye hadn’t even been bothering me much at all, yet he found it to be significantly blocked. Something didn’t add up there for me.

A few months after my first syringe test, I consulted another ophthalmologist who syringed just the left eye. Again, I felt little to no pressure, and I was sure he didn’t push hard enough to clear it out. You see, when performed correctly the syringe test is also a therapeutic treatment. It can clear an obstruction or widen a narrowed tear duct when the syringe is used as a probe and when saline is injected with sufficient force. This time, I was recommended FML (Fluorometholone) steroid eye drops four times a day. That’s the only treatment I was given, and was advised to see him again in three months time if the epiphora persisted.

It continued watering despite the steroid drops, and three months later I returned (now six month since I originally sought treatment). I was given the same FML prescription, with instructions to come back in another three months. During these three months, I learnt how to drain the tear sac myself and noticed mucus emerging. Upon my own suspicions, I used some antibiotic drops from the local pharmacy and actually noticed a decrease in the watering.

On my next visit to the same ophthalmologist, I told him about the antibiotic drops—which he generally dismissed. He kept me on FML drops and advised me to return in another three months. It was winter at the time and the watering was not improving much. After a full year since I had originally visited my GP, I returned for a third visit and finally was referred to an oculoplastic surgeon—again.

This time I decided I should see the surgeon. I wasn’t thinking that I would get the surgery, but I wanted to have someone else look at it anyway. It had been going on so long without improvement that I knew something needed to be done, and I wanted to hear my options from a specialist.

The oculoplastic surgeon syringed both eyes and, indeed, the left eye refluxed the solution and I didn’t feel anything in the throat. The syringing was far more thorough and forceful than the previous two ophthalmologists. The first ophthalmologist syringed the right eye and I did not feel it in the throat, whereas the oculoplastic surgeon actually syringed it with more force and I felt it go into my throat fully.

So I finally received a thorough syringing for the first time after five visits to eye doctors over the course of a year. If I had received such a forceful syringing at the beginning of the epiphora, maybe it could have been flushed out from the start. We’ll never know. But once the oculoplastic surgeon deemed that I had a blockage in the left tear duct, he immediately drew a diagram for an external DCR. I was horrified about the concept of him cutting through bone and the extent and theory of the surgery. I absolutely refused.

This surgeon then offered the endoscopic approach to DCR, but he insisted that it’s not as successful and that he would need an assistant in the room with him, which would cost more money. He was insistent that the external DCR was the best solution. I asked him to attempt probing the nasolacrimal duct (a non-surgical alternative), but he told me that he doesn’t use the procedure, nor does he know anyone else who uses it. When I told him that I’d search for someone, he told his secretary to book me in anyway for surgery.

I left his office with not much hope. I was very wary of the idea of any surgery, let alone one as extreme as bone removal with external DCR in such a fine-tuned area of the body. But who would attempt probing on me?

*    *    *

Weeks later, a friend claimed she had her tear ducts unblocked by a top oculoplastic surgeon. I rung his office asking for probing, not surgery. They said that he could unblock the tear ducts. So I had a consult with him and he did the routine syringing, then went onto a spiel about endoscopic DCR (recall the last doctor pushed the external DCR)—that it’s ‘the best way’. He completely dismissed the idea that the nasolacrimal duct could be opened. I told him I did not want surgery, and he said that I’d just have to ‘live with it’, then.

By this stage, I was really getting sick of the tearing, which had increased, and wanted relief. I reluctantly booked in for the surgery. That is a decision I wish every day that I could undo.

The surgeon did not mention that endoscopic DCR involved drilling through bone—a concept that I found entirely unacceptable. I thought endoscopic DCR was less invasive than the external approach and believed that bone removal was not part of the procedure. If I had known, I would have refused. I certainly did not want bone removed from my nasal area just for a bothersome watery eye. It’s something the surgeon should emphasize—not exclude—during the preoperative consultation. Yes, the watery eye was uncomfortable, but bone removal wouldn’t have been worth it for me. I’d imagine many others would agree.

Complicating the Matter

Possible complications are a huge deciding factor for those considering a non-essential surgery. It’s a matter of carefully weighing the odds and the risk/reward ratio. We all understand that there are no guarantees in life, and everything has risks, but we at least want to know the odds and worst-case scenarios. Prior to the surgery, I was only given the following as complications:

  • Infection
  • Bruising
  • Reaction to drugs
  • 10% restenosis
  • Scarring

This small number of complications gave me the impression of a very safe procedure, which was important to me. Notice the complications are based on the very short term. I was not issued with an information booklet on the procedure (they are available for responsible surgeons to issue to patients). I’ve since seen an information leaflet about the surgery, and it certainly outlined more complications than what my surgeon gave me.

Immediately after the surgery I bled profusely through the nose for many hours. I also had a complication with my heart rate and blood pressure rising and had to stay overnight in hospital.

For the few weeks after surgery I found the silicone tubing very annoying and irritating, but that was to be expected. Overall I was not feeling good, but was still hopeful that when everything healed and settled I would be cured. Unfortunately, the real problems set in when the silicone tubing was removed after five weeks.

I now suffer from severe dry eye, and I believe it’s due to the following:

  1. There is significant air regurgitation through the corner of my left eye when I talk and breathe. This is not acceptable! Apparently air regurgitation upon blowing the nose is a common complication of DCR surgery, but it’s occurring all the time with me, and is very unpleasant to live with. The air regurgitation blows on my eyeball, contributing to severe dryness. I was not advised about this common permanent side effect during the initial consultation.
  2. The puncta (holes in the eyelid they place the silicone tubes through) are very dilated after the tube removal. This seems to have caused an increase in tear drainage, thus tears are being removed from the eye too quickly. The dilated puncta are also irritating my eyeball. Apparently, during the operation, they ‘snip’ the puncta to make them larger. Again, shouldn’t we be told about this part of the procedure?
  3. The hole in the nasal bone may be too large (apparently, it’s 9mm by 5mm).

The dry eye has induced a yellowish white inflammation on inner side of my eye near the iris, and I’m developing sty growths on the eyelid. Both are very irritable along with the dry eye pain. None of these were a problem before the DCR surgery. Before the surgery I just had a watery eye with some low-grade infection. I’d just wipe the occasional tear that dripped over my cheek. There was no pain or irritation involved, and it was much easier to live with than what I have now.

A dry eye is far more dangerous and uncomfortable than a watery eye. The presence of a dry eye leads to keratoconjunctivitis sicca, a condition that causes breakdown of the cornea and eventually possible blindness.

I have to apply artificial tears very frequently—every 15-20 minute—to keep the eyeball moist, as well a thick ointment before bed. Despite the artificial tears, I still feel burning and pain from it, especially with air conditioning and outside wind. I often wake in the middle of the night in pain and having to apply more drops.

It’s very difficult to live with. I find it frustrating carrying artificial tears wherever I go. In the hot weather the artificial tears get hot and burn my eye on application. Again, before the operation, none of this was a problem.

Frequent application of artificial tears is enough to drive anyone insane, especially during work. It has prevented me from pursing my career to the extent I would like to. I’m simply not able to spend so much time at the computer or meet for lengthy consultations. I’d have to reapply them three or four times during a one-hour consultation, which would be distracting both to my clients and myself. Thus, it has become a burden not just physically and emotionally, but financially as well.

Other complications I’m experiencing:

  • Upper left eyelid pain (where tubes were placed), especially when using the computer.
  • The left eye tires more quickly than the right.
  • The left upper eyelid and upper canaliculus occasionally twitches. This never occurred before the operation.
  • Involuntary nerve twitches in the inner corner of my left eye.
  • The inner corner of the left eye (where you would massage the tear sac) puffs in and out as I breathe and talk. There is also a constant feeling of pressure there.
  • Gritty feeling around eyeball near the eyelids (due to dry eye).
  • Pain at surgical site. (I’ve investigated, and it’s not unusual to experience pain up to ten months after surgery!)
  • Frequent headaches, which were not present before the DCR.

I cannot use a computer for very long due to the eyestrain and headaches. This has seriously affected my work, which involves lengthy computer use. Again, this wasn’t a problem before the DCR surgery.

Since having the DCR surgery I’ve noticed my left eye appears smaller. It’s since been noticed and confirmed by a medical practitioner. It’s not the eyeball that’s smaller, but a drooping upper eyelid (giving the appearance of a smaller eye), which, in fact, has occurred in other people whom have had DCR surgery. The difference is clear in the following image:

Notice the difference between the eyes.

This is a less physically serious complication than the painful dry eye, but it is still psychologically unnerving. It’s a problem that I wasn’t told about, and that would have affected my decision about the surgery.

Please see my blog post for a full list of possible complications resulting from a DCR.

How It Feels and the Impact on My Wellbeing

The eye and nose are very sensitive parts of the body. Any change means a permanent awareness of discomfort or altered, unsettling sensation. This is why it should be left alone unless it’s absolutely vital.

I am constantly aware of air gushing in and out of the corner of my eye when I breathe and talk. It feels like someone blowing up a balloon then releasing it. It’s a pumping action that I’ve found very disturbing to live with. The only time I get relief from it is when I hold my breath!

It’s automatically assumed that patients won’t mind the ‘eyelid flutter’ upon blowing their nose after DCR, so they are often not told about it. How dare surgeons assume what we’ll feel comfortable with! I don’t like it at all, and certainly do not appreciate feeling my eye breathe when I do.

When I kneel down to pick something up, I can feel the difference and the tears rolling down the nasal cavity. It’s an eerie sensation.

The air regurgitation and pain from the dry eye has caused me significant emotional distress, especially because of the following:

  • Knowing I was better before the surgery
  • Knowing there were less invasive procedures available
  • Knowing I wasn’t fully informed about the surgical procedure
  • Knowing they cut through my bone when I was against it
  • Frequently having to apply artificial tears
  • Knowing these problems are permanent
  • Constant awareness of the altered sensation between my left and right eye

All of these things have blended to cause a severe depression. I have not been able to work and have had to receive counselling, all because of DCR surgery. All because of a little eye watering.

Lack of Information During Consultation

I’m still confused as to why so many doctors in this field do not regard this surgery as the absolute last resort for epiphora. There is a lot of research that the non-surgical techniques work. They may not have the high success rate of DCR, but they are much safer, quicker and more economical.

Two oculoplastic surgeons could clearly see how opposed and terrified I was about surgery. Still, they dismissed my feelings and pushed the surgery. Neither of them mentioned there were non-surgical treatments that existed. I trusted them, and where did it get me? What can they do for me now? As it turns out—not much.

Close up of my left eye (the DCR eye) showing dilated puncta.

I was never told bone would be removed or my puncta would be snipped and dilated. That alone would be enough for me to absolutely refuse the surgery. It seems obvious to me that if the puncta were dilated, then it would alter the tear flow system and possibly cause irritation. Not to mention that bone removal is a truly extreme invasion and alteration of the body. It is even possible, though rare, to have leakage of CSF (cerebrospinal fluid). Note the conclusion of a study published in Ophthalmologica in 1991, titled ‘Anatomical consideration for dacryocystorhinostomy’:

‘It is obvious that, if a posterior nasal window is enlarged more than 3 mm above the medial palpebral tendon, a bony opening will be formed in the anterior cranial fossa floor in these 6 cases, resulting in cerebrospinal fluid leakage. In conclusion, DCR should be done without severing the medial palpebral tendon to make a bony nasal window under the tendon.’

In fact, one oculoplastic surgeon actually told me he doesn’t tell his patients he removes bone because it scares them away. That says it all. We have the right to know exactly what an operation involves, and it is the responsibility of our doctors to inform us so that we can consent or not consent based on the reality of the situation.

I was never told a large gaping hole would be made in my nose of 9mm by 5mm! This allows air to flow directly from the nose to the eye. It’s no wonder I feel air gushing in and out of my eye when I breathe and talk.

It stands that I was much better before DCR surgery. My eye was normal with just some watering and minor infection that could have been controlled with antibiotics. I didn’t need to carry artificial tears around and there was no pain at all. I would do anything to revert back to how I was.

Inappropriate Medical Treatment

I believe the very first ophthalmologist I saw should not have referred me on without giving me a treatment plan. I would have had to wait three months to book an appointment with the oculoplastic surgeon. Three months where I could have been using FML drops, antibiotics, heat packs, and so on, very early in the development of watery eye. Unfortunately, I was left without treatment and simply hoped it would clear up on it’s own.

The second ophthalmologist only gave me FML drops to use. He did not mention anything about massaging or using heat packs. I also do not think he syringed the tear sac properly. Then, despite the drops being prescribed and re-prescribed for almost a year, the watering got worse.

When I eventually consulted two oculoplastic surgeons, neither was interested in non-surgical intervention, such as probing or balloon dilatation. At the time I didn’t know about stenting or balloon dilatation, which according to studies can work very well—without the complications of DCR. I believe my concerns against surgery fell on deaf ears and I was given endoscopic DCR as the only choice.

My only desire was to attempt to have my nasolacrimal duct opened with non-surgical interventions. I very much wanted to feel that block being pushed through, either with probing, balloon dilation or stenting. Indeed, stenting now sounds the most promising from the three options. If the stent gets occluded, it can simply be removed and you’d still have a patent tear duct. Indeed, it could have worked for many years without any complications.

So why did I sign up for the surgery if I didn’t want it? Basically, after hearing more than one top oculoplastic surgeon emphatically tell me that there is no other way, then having them explain how ‘simple’ and ‘safe’ DCR is—I think I made the choice most anyone would. I followed what I thought was sound, thoroughly considered professional advice. If we can’t trust our doctors, whom can we trust?

If you have a blocked tear duct, I urge you to persist till you find someone who will do what you want. Don’t be pressured into something that doesn’t feel right by pushy doctors. Make sure you get all of the available information on a procedure before committing to it, even if that means going home to research and ‘think it over’. This is not an emergency procedure. Don’t let anyone rush you.

Non-Surgical Approaches to Adult Epiphora

There are studies to prove stenting can work up to 60% of the time in adults with epiphora. Stenting is an office procedure that takes only minutes to perform and opens the natural tear duct. Surgery works 90% of the time. My argument is this: why risk all the complications of surgery for a mere 30% increase in success rate? Not to mention the permanent change to anatomical structure, altered sensation, possible life long discomfort, pain, and unknown long-term complications of bone removal. And let’s not forget that the operation may fail, too.

It simply doesn’t make sense. In fact, it’s ridiculous—but they continue to push DCR as primary treatment. Just because my eye doesn’t water anymore, does that really make my surgery a success? Not in my view. But when they generate these statistics, I am considered a success—as are all of the other unsatisfied ‘cured’ customers.

I think the British Journal of Ophthalmology put it best in a short article for the September 2002 issue, titled ‘Dacryocystorhinostomy for partial nasolacrimal obstruction’:

‘The importance of giving a thorough trial to less invasive treatments such as forced syringing, stents, balloon dacryoplasty, and silicone intubation before undertaking a DCR in such cases has not been adequately emphasised. It is true that variable results have been reported with these techniques, but there are studies which show success rates as high as 73.3% with antegrade balloon dilatation combined with silicone intubation even in cases of complete nasolacrimal obstruction over a 1 year follow up.’

I was denied procedures that very well could have provided a perfectly functioning eye, no complications, no difference between eyes, no pain, no bone removal, and so on. It’s okay with the surgeons to cut us up with DCR, but for them the complications are all statistics and theoretical possibilities. For us, these complications are real, and we may carry them for the rest of our lives. Don’t we deserve a choice?

Believe it or not, DCR has been used for over one hundred years. It’s an old technique they’ve refined, but the theory remains the same. Surely, in this day and age there are less traumatic methods to treat a blocked tear duct. In reality, drilling through bone and slaughtering the lacrimal sac open and forcing it to join the nasal mucosa sounds barbaric and extreme for a simple watery eye.

If dry eye doesn’t occur, then there is still a disturbance in balance between both eyes. That’s why I firmly believe the natural nasolacrimal duct should be unblocked with all the methods available. If they haven’t worked, then at least there was an attempt. Furthermore, who is necessarily looking for a complete cure? Some people (like myself) were only looking for a reduction in tear flow. A moderate improvement is better than surgical complications. It’s argued by many surgeons that these alternatives do not work in the long term. But who necessarily wants that? Maybe a short relief from watering is enough. Ten months of relief is very good in my opinion. You can always go back for a repeat or try a different alternative.

It’s up to you. It depends on how you feel about what happens to your body. Some people don’t care if bone is drilled out and are willing to risk complications. As long as it’s a long-term cure for watery eye, it doesn’t bother them. But many, many others would disagree. Shouldn’t we all be treated on our own terms?

Two weeks after my endoscopic DCR surgery, I discovered there was stenting available. And yes—surgeons available in Australia who will probe and use stenting on adults. Knowing I could have prevented the surgery is demoralising. Why didn’t I discover this before the surgery? Because I was pushed and bullied into the surgery by being told no other options exist and being given the sales spin on DCR. I believe this is not only unfair—it’s unethical, even immoral. It is, without a doubt, entirely unacceptable.

See my blog post for more information on DCR alternatives.

Challenge for Surgeons

What to do when DCR goes wrong? Shouldn’t we have an option to ask for it to be reversed, especially if not given enough detail of the operative procedure and complications? Has anyone ever totally reversed DCR surgery before? Have you ever closed the hole in the nasal mucosa? What was the result?

I’ve sent my request via email to countless eye/lacrimal surgeons around the world. Not surprisingly, most have ignored my email. It seems surgeons can be quite dismissive when it comes to a patient who’s had complications—as if they don’t want to deal with damaged goods.

How could you do the following?

  • Replace the bone that was cut out
  • Detach the lacrimal sac from the nasal mucosa and close it up again
  • Close the hole in the nasal mucosa
  • Decrease the size of the puncta

For my air regurgitation and dry eye, I was given the following ideas (none are particularly appealing to me):

  • Punctal plugs or permanently closing the puncta
  • Replace the silicone tubing back into the canaliculi and through into the nose
  • Rough up the nasal mucosa to cover the hole
  • A donor piece of skin to cover the hole in the nasal mucosa

Firstly, punctal plugs can migrate and fall into the lacrimal sac, requiring an operation for removal. They can also cause infection and scarring. Also, they would take me back to square one with the watering. Now, square one doesn’t sound too bad to me right now, but at what risk? The puncta are natural openings for tear drainage, what are the long-term repercussions of closing them? Again, there’s been too much altering of the body.

The silicone tubing placed back into the canaliculi (as is done during DCR) is not appropriate because it’s very irritating on the eyeball. In fact, I couldn’t wait to get it out. There’s also a risk of corneal abrasion, scarring, and infection of the canaliculus with long-term use. Furthermore, I still feel the upper canaliculus. It’s painful and twitches from having had the tubing in it for five weeks.

In Closing

Help make a change to this protocol by raising awareness of alternatives and insisting that you are treated according to your own level of comfort. We have to hold these doctors accountable and let them know that pressuring wary patients into potentially dangerous surgeries is entirely unacceptable.

If you have a story to tell related to DCR, please speak up! Contact me with your experiences. If you’d like, I can even share your story on this site, anonymously if you’d prefer. It’s so important that we do not remain quiet about this. The medical community needs to hear us and change this protocol. Irresponsible surgeons need to be held accountable. We are not just customers—we are patients, helpless and trusting.

We need to live in a world where we can trust our doctors to have our best interests in mind, who will listen to our concerns and wishes and take them seriously. Help me make that more of a reality.

NEW UPDATE: Want to know how I’m doing five years later? Visit this page and find out.

 

 Posted by on October 9, 2012

  128 Responses to “My Story”

  1. Mai Yang says:
    March 20, 2013 at 8:27 pm

    I just want to thank you for ALL your information and this site!
    It’s very helpful to me. I have been experiencing watery eyes for about a year now and when I went in to see the specialist, she said that I HAD to do DCR and there was no other way. I don’t want to do the surgery at all so I told her I’ll think about it. I have been looking up other ways to go around it and happened to stumble upon your website. So Thank you for all the information! I really appreciate it! I will surely try out all the other possibilities before even thinking about SURGERY! THANK YOU!

    Reply
    • George says:
      March 20, 2013 at 11:16 pm

      Mai, you are very welcome. Please keep us informed with your progress. Yes, most will simply suggest DCR which in my opinion is malpractice. Keep persisting and you’ll find an understanding ophthalmologist who’ll use the less invasive techniques. Most people simply don’t question their doctors choices and do as they suggest, I’m glad you are studying this and checking the pros and cons. Again, please let us know how you are progressing.

      Reply
    • Grace says:
      December 16, 2015 at 7:41 am

      Thank you, for your contribution it is very insightful. I think why doctor offer surgery is that is all they are taught, and “when all you have is a hammer everything looks like a nail.”
      I’m very sorry you are sufferings I hope this information
      might help bring some relief and maybe a cure!

      I saw five ophthalmologist for the dry eyes one put in plugs for dry eyes, they fell out. The second doctor,gave me a wonderful steroid drop to get rid of the inflammation of my eyes, The third doctor ran a test to check if the tear flow was normal and it was so he loaded me up with several drops. The fourth ophthalmologist told me to take vitamin A and beta carotene oil, flax seed oil . Fifth one told me just to lubricate my eyes with Genteal and allergy drops.

      Now this is interesting one day I saw a young college intern optometrist and he goes close your eyes and I did . Then he told me that you are not closing your eyes completely shut it is very slightly open perhaps it is enough to dry your eyes out. and suggested an eyes mask a wide one, which I ordered on Amazon which keeps my eyes shut completely when I sleep, Why couldn’t of one doctor told me all of these things!

      On the same day I went to naturopathic doctor he told me to buy castor oil in that is in glass bottle, and then rub the castor oil over my eye lids and around my eyes, then just lean back and close your eyes, and use warm compress or heating pad over my eyes the oil supposedly is restoring the eyes, and is healing. and he told me to do oil puling, I did the oil pulling,oil pulling is basically put a tablespoon of sesame oil in your mouth and keep swishing it around for about 10 minutes the oil will get foamy as you keep swishing,
      then you spit it out, and I brush my teeth Oil pulling did the trick it lubricated my eyes, Oil pulling was discovered by a doctor and a lot of people are doing it now ,

      Reply
      • George says:
        December 16, 2015 at 8:27 am

        Thank-you for your contribution and suggestions Grace. The lipiview machine can determine if there is incomplete closure of the eyelids upon blinking and is a very common cause of dry eyes. Indeed an eye mask during sleep and daily eye exercises designed to strengthen the muscles of the eyes, eventually will produce complete blink closure. I’m also baffled why so many eye professionals do not diagnosis an incomplete blink. In fact, they miss many things, such as certain medications that cause dry eyes.

        I’ve never heard of the swishing of sesame seed oil, then brushing your teeth with it’s foam. I cannot see the mechanism how it could assist dry eyes but I’m glad it worked for you.

        Careful not to get castor oil onto your eyeballs, but placing it over closed eyes is fine and is anti-inflammatory. Heat packs is always recommended for meibomian gland dysfunction. Thank-you for the tips.

        Reply
    • lorie says:
      September 18, 2016 at 6:21 pm

      I had dcr on Friday 9/2/16. I feel like a idiot and wish I would have read your blog sooner. Something in my gut didn’t feel right but I just believed it was ok since if it wasn’t medically necessary the insurance wouldn’t have approved it. The MD never told me he’d be drilling thru bone. He only told me he’d be putting a stent in. He never told me the risks or possible complications such as meningitis. He didn’t explain anything well & it was done at UCLA and he says oh dr luu will be helping me with this surgery. Well I have a feeling the dr luu was a student or resident who did the surgery instead of him. He didn’t really explain post op care either.
      So on day 2 post op, I felt what I thought to be boogers from my nose. It was the tube. I didn’t mess with it. I called the MD and he sounded pissed and accusatory like I caused it intentionally. He then said I can pull it out but it’s attached to my eye so I cut some of it but not the sutures.
      He said my chances of 85% success were now 65% when he never told me the success rate prior to the surgery. I asked about keeping post op appt and he said if I wanted to but I could come in a month. He has a poor bedside manner. Anyway it disappointing to say the least. I feel a air bubble sensation in my nose and the tube keeps poking me on the side of my eye and I am so bruised like a dark purple. Is this normal? I don’t know how to attach a pic. At the post op appoint, wed 9/7/16 he said stent was surprisingly in place but on Thursday 9/15/16 it came out.
      Air now comes out of my eye when I blow my nose, I have a bump on the side of my nose, my eye waters like a fountain, my lid like George’s is dropping and the eye look smaller in addition to having decreased peripheral vision. UCLA gave me a survey I think I’m gonna fill it out and be truthful about my horrific experience.

      Reply
      • George says:
        September 19, 2016 at 4:52 am

        Hi Lorie, I’m very sorry to hear that you’ve gone down the path I did several years ago. It’s scarey to think these changes could be permanent in such a delicate area of the body. You can’t easily escape the feeling of air regurgitation from your eye and who wants it? Well, they “assume” it’s something patients can easily live with so they don’t tell us, despite it’s a very common complication of DCR surgery. Neither do they tend to tell you that a ‘hole’ will be drilled through a nasal bone. Now, that’s something a patient would want to know! In fact, I spoke to one surgeon about it and he stated that he ‘purposely’ doesn’t inform his patients about the drilling because they would change their minds about the surgery.

        However, there is good news! From someone whos lived through this, time does heal. You’re only at the beginning but the body is an amazing self healing mechanism and will attempt to close the hole that was drilled. Over time, it reduces in size and you’ll find the air regurgitation will be less.

        When they remove the bincanicular tubing the tearing should reduce or stop completely. So Lori, there is good news ahead 🙂

        Please do keep us updated with your progress and wishing you a speedy recovery.

        Reply
    • Diane says:
      September 24, 2016 at 9:12 pm

      My 94 year old Mother is about to have the surgery. The Eye Doctor told us he would have to open the Tear Duct and she would have to be under General Anesthesia. He never mentioned DCR, so I am assuming he is only ‘opening’ the Tear duct with something sharp. And that is why she is under General Anesthesia. She has put this off for about a year because she did not want the Surgery. Her right eye is perpetually black and blue near her nose, and that part of her face is swollen.

      It obviously has been infected for a while, and the doctor said it could go to her brain if not treated. They gave her ointment and eye drops. Also antibiotics at one point. And because she did not want the surgery, the antibiotics went on for a while. That caused a stomach problem and she had to take meds for that in June!

      At this point I am not sure what to do for many reasons. Blocked tear ducts are supposed to be a problem for some elderly people. I thought also that Anesthesia was not an option for older people.

      Reply
      • George says:
        September 25, 2016 at 4:33 am

        Hi Diane, Most likely the surgery they are planning for your mother is DCR. There’s no need to use general anaesthesia for the ‘alternative methods’ on most occasions.

        I know my website warns against DCR and brings to light the serious complications. However, your mother is at a different level here…

        * Her age – we just want the surgery to work. There’s no point trialling with probes, and balloon dilatations. The less we put her through, the better.

        * The infection – There’s no point in waiting and allowing an infection to get worse. It’s putting your mother’s already fragile body through more stress.

        We want to make the rest of your mothers time on earth a happy one. No hassles or complications. DCR complications doesn’t happen to everybody and we have to weigh the benefit to risk ratio. It would seem the ‘benefits’ would outweigh the risks here Diane. I’d phone the surgeons office and clarify if they are proposing DCR (Dacryorhinostomy).

        Let us know what you discover and good luck!

        Reply
    • Helen says:
      March 13, 2018 at 5:10 am

      Thank you for sharing all of this information, I am due to receive DCR in both eyes and I have no watery eyes only partial blockage. I am sorry you had to go through so much distress with regards to your eyes. Sincerely thank you for sharing your experience.

      Reply
  2. http://Tinyurl.com/ says:
    April 15, 2013 at 6:27 pm

    I actually Believe blog, “My Story

    Reply
  3. Tony says:
    May 2, 2013 at 4:23 am

    Hi George,

    First of all I just wanted to thank you enormously for the wonderful information you have shared with us all on your blog. I’ve got no doubt it will help a lot of people before they potentially walk ‘blindly’ into getting a DCR done without knowing the full picture/story and consequences of the surgery.

    I certainly don’t envy your situation but unfortunately like yourself I have had a very similar thing happen to me with various opthamologists and oculoplastic surgeons badly letting me down with my left eye. Fortunately, I have not had the DCR procedecure done yet and I’m very pleased I have not after I found this blog.

    So on that note I would also like to share my own story – which is somewhat similar to George’s (at least in principle) but hopefully I have a different outcome.

    First of all though:
    In my opinion people like ourselves are let down for a variety of reasons from those in the medical industry. Quite sadly because some in the medical field think they are the be all and end all (like I’m the doctor so I must be right). Others from lack of accountability. Others are just followers and will just practice what everything else is doing and therefore be reluctant to try anything outside the norm (that might be helpful). Finally there are some that are just old-school and so what they learnt/read in a textbook years ago they still apply in their practice today (not a big fan of these type).

    A harsh criticism? I don’t think so. No one in the medical industry is perfect like any other industry.

    Lessons to be learnt? I’m a big believer in self-diagnosis. OK you can’t always get it 100% right but you should do some research on your condition. That will allow you to be firmer/more direct with the particular specialist you are dealing with. If you feel like they dismiss what you are saying completely without anything logical in response I would say move on to the next specialist. Unfortunately, if some of these guys worked in the technology space we’d still be watching black and white tv 😉

    Anyway here’s my story…

    I’ve had a problem (for quite some time now) with just my left eye. It get’s watery and also I suffer from discharge from it. Now it’s important to note that the discharge only happens right near the corner of the eye and obviously where the punctum is located. Which is why to me I’ve always believed there to be a drainage problem of some sorts (as my right eye is fine). That might sound obvious (saying it’s near the corner) but some people complain of having discharge right across their eye and under eyelids etc. But I don’t get that.

    I can deal with the watering but I wasn’t happy with the discharge. It wasn’t so bad in the beginning but slowly got worse and worse and so I thought I should get something done about it. I mean the fact that it was just one eye didn’t make any sense to me and eye drops were only a band-aid fix in my opinion.

    So I started by going to see some eye opthamologists first. I think the first one or two couldn’t see much of a problem at all and I remember one putting it down to allergies and giving me some specific eye-drops (allergan I think).

    They didn’t even do tear drainage tests (which they should have done). Although I didn’t say so at the time (as it was only early days) the allergy diagnosis was just stupid. My eye’s never got swollen up, red and itchy and all those other typical signs of allergies. There’s an example of a bad and lazy diagnosis in my opinion. Unfortunately, I think some of these guys just see too many patients a day and then just propose a hopeful solution and think right I’ll see you in six months or never again..

    So I gave the opthamologists a break for a while and just carried on in life. After some time I went and saw another one. He mentioned eyelid hygiene as being the source of the problem. Saying really I didn’t have dry eyes. I agreed with him as I believe I only suffer very minor dry eyes but I was not happy with the diagnosis and what he mentioned didn’t help.

    So a period of time went on and I was researching online one day and discovered oculoplastic surgeons (who’m I’d never heard of before). I liked the fact that they specialize completely in eye’s and readily did surgery for things like blocked tear ducts.

    So I got a referral from my doctor to see two of them (second one as back-up as didn’t want to take chances).

    Now the first oculoplastic surgeon did the syringe test for blocked tear ducts (which George mentions further up on this blog). As George mentions “A syringe test works by injecting a saline solution into the tear sac through the puncta (the tear drainage holes) in the corners of your eyes. If you cannot feel any solution in your throat and if there is regurgitation of solution back out of the puncta in your eyelids, you are deemed to have a blockage. Then, in short order, you are recommended to have DCR surgery.”

    Because I could taste the solution in my throat he said that in fact that I had no tear duct blockage at all. I explained to him that I believed I did and it was only a partial blockage. He disagreed and so that was that.

    Now before I continue I would like to mention this about the tear duct procedure currently performed (that was later confirmed by my second oculoplastic surgeon without me mentioning).

    IT’S JUST WAY TOO BASIC IN MY OPINION:
    Think about how basic the process is from 3 angles:
    1) Time Period: Sure they force a syringe into the corner of your eye and if you can taste it then you are deemed to have no blockage and if you can’t you have. OK but taste it in how long? 1, 2, 3 or 4 seconds? If someone can taste it in 1 second as opposed to 4 seconds are both people the same? Sure a tear duct drainage system would differ from person to person marginally. But my point is this…just because a person can taste it doesn’t mean they have no blockage…maybe just a partial one (that they tasted in 4 seconds instead of 2 seconds).
    2) Natural Force: If you push a door opens it opens. If you push a door harder it opens harder/faster. The same with all other things you apply force to in life. So back to the test isn’t it natural if you forced something into someone’s eye with a syringe that you would taste it at their end? For those with a proper blocked tear ducts maybe not. However if you have a very minor or partial blocked I would think not always. When does such force usually get applied to the eye area?
    3) Force Applied: George mentioned something about not being happy with the force applied with his syringe. Which raises this point….what if someone doesn’t force the syringe hard enough and then deems someone without a blocked tear duct to have one?

    I’m sorry I just think this test is complete garbage. It’s like counting the toes on your feet and saying you have ten so none are definitely broken.

    Solution?
    Do an X-Ray or probe for god-sake. Sure in some cases the basic test might be ok but I think patients should be giving the option to have an x-ray done to confirm. Surely this is more accurate and will give patients a clearer picture.

    So not long after I saw the first oculoplastic surgeon I went to see the second one. At the time I found this oculoplastic surgeon a lot better and more thorough overall. I believe they sensed my frustration. They advised me I have a partial narrowing and a partial blockage evident from my left tear duct. It was frustrating to know that it took that someone that long to diagnose it.

    I asked for the solution and they mentioned the DCR surgery immediately as the only option. They said it’s the only way to know exactly where the blockage is. Now at the particular time I didn’t have any problems booking in for DCR surgery because I just wanted to solve my problem.

    However, after researching online I found a number of bad posts and experiences that people have had after DCR surgery. In particular, I found George’s blog very interesting and I’m glad I found it in time (with my surgery not schedule until the end of the year).

    Whilst obviously I want to resolve my condition I don’t want to replace it with a worse condition e.g. using eye drops every 15 minutes.

    So right now I’m unsure of my next steps but after reading George’s blog post as well as my own research I’ll be investigating further to locate surgeons that will fix my problem without having to resort to DCR surgery.

    Overall, after my own experience I would say the key is to be confident and assertive with whatever specialist you are visiting. Indicate to them what you may believe the problem is and mention to them any concerns you have. If you feel a specialist is not listening or easily dismisses you I would say move on to the next. Don’t be afraid to present specialists with information you have found online too. Yes, many will dismiss it but if you dig deep enough you can find specialists that will do things outside the box.

    Tony

    Reply
  4. MURDEL GORDON says:
    May 21, 2013 at 10:14 pm

    I have tear duct problem the rye doctor operate on it in 05 and it became worst I went back to him and tell him my eye was worst he said well I did not say it would solve your problem permanently he bill the insurance seven thousand dollars I call the union and complain they did not do anything the same eye doctor told me that there is another operation that I can do he said something like I can put a gutter like tube under your duct but your nose would become runny and his comment was it would be much better the mucus coming from your nose than your eye I refuse the operation he said well there is nothing else I can do for you in 2011 in another state another doctor say it because he did not do the top tear duct I believe her she did the top eye duct my eye even get worsen now this time it was medicaid so I don’t know how much she bill medicaid so since year 2002 I am suffering with tear duct problem while the eye doctors enjoying the thousand of dollars they benefit off my suffering (SO SAD)

    Reply
  5. Thomas Sawyer says:
    August 31, 2013 at 3:11 pm

    I just wanted to see if there are any other people experiencing the same issues funny I found your site. You see I to wish I could reverse the decisions that I made and go back to having a minor issues .As I sit here with my right eye selling up again and an extreme headache I wonder if my life will ever be the same. I am only three weeks post op and have had severe problems since waking up from this procedure I was to was less invasive and would cure my problems. I had punctual plugs placed in my lower ducts and the doctor kept thinking they were falling out well 3 years later I am told that they had migrated into the caniculi and my duct was block 100% again I was never informed that these plugs would cause this situation. So after several attempts to clear the duct with forced flushing my doctor persuaded me to have the stents put in I was having serious drainage and infection in my right eye .He put me on Tobradex with a steroid and this seemed to have slowed the infection down mindful this was 3 months later. So with the surgery set and all the information I could find all the questions I could ask we decided to go with the stents as the least invasive procedure. Immediately after waking up I knew something was not right my right eye felt like it had a nail in it my nose lip and upper right quadrant of my front teeth were numb I was told this was normal and sent home.3 days post op my eye was swollen shut and on fire the infection and drainage was severe and I called his office of course he was not in and was old to go to the emergence room well we all know what that’s like so I sucked it up or one more day I did ask for him to call in some antibiotics but was told he would have to see me first.Got into see him first thing Monday morning he looked at my eye and told ne the stent would have to come out if the infection would not clear up I was also told that the numbness was not normal and that he never had these issues before he sent me home on oral antibiotics and mad another appointment to see him in a week. I died for a week my eye was swollen shut and severely infected I called his nurse and she told me to come in.He seemed another perturbed that I was having these issued and removed the stent in my right eye I thought someone had jabbed a hot poker down my eye and then there was a gush of nasty fluid in my throat. It has been 5 days now and my right eye was starting to feel better last nigh this lump started to form about mid lower eye and it is very painful now it has migrate to the corner of my eye and has grown in size of course it is Sat and he is no where to be found again was told to go to the energy room right lol.If I were told that these punctual plugs would have caused this I would never have let them be put in I wish I could go back to that minute and reverse the procedure worst part is that I blame myself for letting him do it I do not want to have the DCR done as I fear the results will be catastrophic so where do I go from here I’m tiered of the whole thing .

    Reply
    • George says:
      September 6, 2013 at 4:25 am

      Hi Thomas, I was wondering what was the original procedure you had done and created the need for punctal plugs? I hear what you say, sometimes it certainly is best to live with a minor condition than risk a surgical procedure to fix it. All surgeries carry risks and no doubt a DCR procedure, drilling through bone and snipping the punctums of the eyelids is no ‘simple’ procedure as the eye surgeons like to put it.
      I hope you are doing better, please do let us know.

      Reply
  6. venus says:
    September 8, 2013 at 3:36 pm

    Thanks for the information you shared to us. I have been suffering a teary eyes for more than 8 years. I had it check with an eye specialist only now and recommend for a DCR surgery right away. And, I’m very reluctant enough. Unlike your case, my doctor did tell me about the drilling of the bone on the nasal area which I will actually hear it. Also, that I will be awake during the whole procedure. It really discourages me a lot. Upon reading your story, I found out that there are more cons than pros. For now, my decision is firm not to entertain the idea of DCR surgery. Anyway, I can manage my situation.

    Reply
    • George says:
      September 9, 2013 at 3:39 am

      Hi Venus, you made the right decision. Not only because of the potential risks but because you only got the option of an “External DCR”. I received an “Endoscopic DCR” which is performed through the nose and leaves no scar on the bridge of the nose.
      Most patients that remain conscious during DCR are most likely to be having an ‘External DCR’ where they completely cut out a piece of your nasal bone and remove it to gain access to the lacrimal sac and nasolacrimal duct. They then replace the bone. Many patients complain of swelling and a dent in the surgical area many years later. The scar is only noticeable if looked at closely.
      Again, congratulations for opting out of the surgery. In terms of the tearing, place some vaseline under the eyes to prevent dripping down the face.

      Reply
  7. Lu Mercieca says:
    December 4, 2013 at 5:52 pm

    A big thank you for such detailed information!! for a year now I have suffered a watery eye.. had it checked.. two months or so of different eye drops and then finally antibiotics, 2500 mg, two differenrt type, five times a day, for seven weeks. As soon as i started the antibiotics, i got a horrible absess, which kept coming and going for the seven weeks…. it seems that my tear duct is not only blocked, but also infected. then i had surgery, just local, when they drained the cyst, packed it with antibiotic guaze and told me i didn’t need to go back for two years.. then after two weeks the same thing happened and i was back on antibiotics! this happened again a few times. I have now learnt how to handle myself, by keeping the eye very clean. Fortunately, I haven’t had an absess for two months now. I would like for you to see the photos of how i looked.. .. not a pretty sight.. I come from Malta. I have been to four different eye specialists and ENT specialists and received different opinions re the need for operating.. some say I won’t get better if i don’t have the DCR,, others make me aware of the risks and don’t recommend. Right now it seems to be under control , but it was ruining my life. I work in marketing and I couldn’t face people looking how I did..thanks again for all your information.. it really helped me…

    Reply
  8. LBSullivan says:
    December 6, 2013 at 11:45 pm

    Had internal nasocanicular duct sx a cpl. yrs ago. the tubing still intact but the lower & upper puncta are swollen, dry feeling and I have a constant watering. Red, dry skin under eye. Occ if I blow my nose too hard I can feel the filament in my nostril & I really wanna pull it out! is there a danger of ripping, tearing, I want this gone.

    Reply
    • George says:
      December 7, 2013 at 1:29 am

      I can really only advise on DCR surgery. This surgery requires bicanicular tubing to remain through the upper and lower pucta and into and through the osteum (hole) drilled through the nasal bone for several weeks to ensure it’s patency. It’s usually removed after 6 weeks or more. You may need to see another surgeon to determine if you need to have it removed.

      Reply
  9. Louie says:
    January 21, 2014 at 11:53 pm

    Hey George
    Thanks for sharing your story. I’ve had a clogged tear duct (right eye) going on 7 years now. I’ve never met anyone who has this condition so I’ve always felt like I’m the only one. It’s comforting but also sad to hear of others who are suffering as well. I don’t know how common our condition is.
    I’ve seen the best of the best. Living here in south Florida, I’ve been to Basom Palmer, a recogninized institution with their specialty being strictly eyes. Anyway, an oculoplastic surgeon there and a respected leader and thinker (I won’t mention his name) did exactly what others have shared. He did the syringe drain test and when it did not drain he immediately mentioned DCR surgery.
    No stenting, ballooning probing, or any other alternative was given me. Since I feel that surgery s akin to a tourniquet and should only be done as a last resort, I asked him (naively of course) if there was no way they could just insert something in there and unclog it like you would a drain and he said “No, that is not a possibility, DCR surgery is the only way to solve my problem”.
    I scheduled the surgery, but deep down inside I was bothered my the lack of trying anything else or of even remotely sharing with me the extent of the surgery and the potential ramifications. All he did was give me a flyer/pamphlet that explained Ocular DCR and he was gone, on to see the next patient. I even went to see him a second time, just to make me feel at ease about the surgery and again his recommendation was the same. The only difference was that now he gave me an option of endoscopic surgery instead of just external surgery. Needless to say, I left feeling the same way as before. Afraid,insecure,and upset at my constant watery eye.
    Well, that was 5 years ago and I decided not to do the surgery thinking that I needed to be better informed and that maybe by a stroke of luck, advances in technology would give me better options.
    Sad to see that in 2014 we are still talking about DCR and its barbaric procedure and outcomes. If I had not read your story I might be experiencing the same thing. Because after 7 years with this (its gotten worse) specially when it’s windy or cold, etc. I’m tired of living with constant tissues and watery eyes. No one has mentioned this, but my condition acts up when I eat, for some reason, I have to be constantly drying my eyes.
    Anyway, here I am still looking to correct this condition. While I can and have lived with it, I’m afraid that someday it’s going to get infected and then I’m going to have to deal with other issues. So yes, I’m still looking for a permanent solution. If anyone has had success with alternative or non invasive procedures, please share. While its good to see I’m not alone in this, I still think we are a tiny minority and that these eye specialists that we are seeing just want to do the surgery rather than try other methods. And while your experience has scared the dickens out of me, we should not have to settle for either permanent watery eyes or a lifetime of horrific surgery outcomes.
    Thanks for this most valuable blog!
    Louie

    Reply
    • George says:
      January 22, 2014 at 6:57 am

      You are welcome Louie. Congratulations for going with your gut feelings five years ago and refusing DCR. What country are you in? There are certainly more empathic oculoplastic surgeons whom use the non-invasive techniques on adults. It’s simply a matter of finding them. Forget your last surgeon whom recommended DCR, he/she wasn’t considerate of your concerns and continued to push ‘against’ what you didn’t want. That’s wrong, we are humans with emotions and doctors seem to miss that point. Having said that, there are some amazing surgeons out there willing to try all the non-invasive procedures as possible. Please be persistent and spend your time locating them. Make a list and phone them all, ask if they perform ‘probing on adults’, ‘balloon dilatation’, ‘stenting’, etc. Good luck!

      Reply
    • Julie M says:
      March 8, 2015 at 5:14 am

      I too, have a blocked tear duct, right eye. I was given 2 options by my Occular surgeon, and I chose the least evasive. He said he was just going to insert a think tube into the duct to open it up. That didn’t sound too bad, the other methods, was the DCR and sounded very scary and complicated. I decided to be brave and go in for the first option surgery. You will never guess what happened. I came out of the surgery with a bandage all over my right eye, and I thought I had the surgery. A nurse came out and told me that I did Not have the surgery, because I sneezed, then hemorrhaged, and the Dr. had to stop the surgery and save my eye and me! When they took my bandage off the next day, my eye looked horrible! The lower eyelid and area was all distorted and black and blue. My eye had to heal for quite awhile, and to hide my horrible apprearance, I bought tinted blue glasses and wore those to work for 6 weeks so no one would look at me. My Occular surgeon did apologize, and he did fix my lower eyelid. He had to make an incision and do a in-office surgery to lift the lower eyelid and match my left eye. He wanted me to try the tear duct surgery again, but I was just too afraid. I am still living with a watery eye, but it doesn’t seem so terrible, just to blot the corner of my right eye with a Kleenex a few times a day! it has been 5 years.

      Reply
    • Rasheed says:
      September 11, 2016 at 5:40 am

      Hi louie,
      i read your story and noticed that i have similar story. i had a watery eye problem for 25 years . i saw the eye doctor oversea and ordered DCR surgery i refused. in 2008 went to boston medical center where i thought i would find a better solution, however they told me the same thing i was scared from DCR. Now, i am going back to see mass eye and ear in boston to see what they will say because my eye getting irritated while i am driving at night and in cold weather i suffer a lot. i am still confused what to do. after i read your story and george’s story i think i will never go for this surgery.
      i would thank you all for sharing your stories. i think i will never go for DCR surgery. i will keep my eye as it is. God bless you all.

      Reply
  10. rev.van says:
    February 5, 2014 at 6:12 pm

    I was going to have this surgery done this month, but something in my spirit said no!!!! After reading your blog about it ,I really decided to stay with my higher power and just go without. I pray that people would take time and find out about these procedures before the worst happens. The doctors need to be more honest in telling you all the risk of these things instead of looking at you like a big dollar sign…..Thank you for the infor.

    Reply
  11. Vik says:
    February 14, 2014 at 5:23 pm

    Hi George,
    It is really painful to read your story. But I am really not sure what else can be done, since in my case it seems there is no way around but the DCR.
    My problems with the right eye started about 10 years ago. I have had always some tearing at the beginning and them a very very acute event of dacryocystitis – a very painful inflammation in the corner of the eye. Nothing helps with it to me – but the irrigation – when they pressed hard enough I would swallow some stuff and the relief is immediate. The doctors (ALL OF THEM) claim that my case is unusual since the irrigation never works as a treatment, it is only the diagnostic method.
    Well, I have had may be 7-8 episodes like that during the last 10 years – all of them are same – very acute and the relief is immediate after the irrigation. No tearing, nothing – untill the next one is coming.
    However, last summer the tearing appeared again and nothing helps anymore. I have seen my oculopastic doctor three times since then, and he irrigated the duct and i swallowed something but the tearing is not going away. So he suggested the surgery.
    And I went to another oculoplastic surgeon – for second opinion. And he said that since I am young it would be good to have CT-DCG to see what causes the obstruction because sometimes it could a malignant tumor there as well.
    And I have had my CT done. What they see is a 6mm x 9mm round shape non-specific soft issue right at the top of the sac which they can’t interpret. They suggest MRI for further characterization and I am waiting for my appointment.
    I am wondering if other people have their sac tested before the surgery? Do you know what was the reason for the obstruction in your case? I don’t believe that if there is a real fibrosis/scar tissue they can do smth with it besides the DCR. At the same moment. I am horrified with your experience – have no clue what to do.
    Thanks a lot for any suggestions and I wish you find the right doctor who can help you.
    Vik.

    Reply
    • George says:
      February 15, 2014 at 2:48 am

      Yours is an interesting case. The infection in your tear sac is usually due to pooling of tears since it cannot drain out. Yet during the irrigation you feel the saline in your throat. However, they are pressing the syringe rather hard so the opening maybe very shallow. That all pales into insignificance with the new diagnoses of the soft tissue on top of the sac. It seems it’s at the far end of the canaliculus. If that’s the case, then I don’t see the need for a DCR which is to create an artificial pathway by cutting through your nasal bone – it’s absolutely horrid. The problem with tearing will still occur, even after the DCR because of the obstructions location. I would encourage the MRI and then find somebody to use micro surgery to obliterate the soft tissue they discovered. Keep investigating and searching. And please don’t listen to no one surgeon who simply recommends DCR like handing out lollies.

      Reply
  12. Vik says:
    February 15, 2014 at 11:35 pm

    George,
    Thanks for your reply. I believe all of the DCR patients have had in fact some sort of obstruction. As far as I can see in the literature it is often located right below the sac-canaliculus junction – exactly where mine is. It could be a scar tissue formed because of numerous infections and invasive syringing – this is one possible explanation that the doctor told me. Another option, it could be a pool of tears and mucus. And the worst, it could be a tumor. Yes, I will have an MRI done. It is just a matter of a long waiting time here in Canada, unfortunately.
    Assume I have the best case scenario and it is just the scar tissue, you are saying the bypass method won’t work? Aren’t they bypass above the junction? Otherwise, I won’t make any sense since the obstruction is often at the very top. Do you think there is a fair chance this soft tissue to be a malignant tumor?
    My regards,
    Vik

    Reply
    • George says:
      February 16, 2014 at 9:26 pm

      You may have read the literature, however not all blocks occur in that area. My surgeon never performed a Macrodacrocystogram to discover where the block is. It was only after the DCR surgery I had consulted someone else and “demanded” the test and discovered it was at the distal end of the nasolacrimal duct…the opposite end of where your obstruction is located.

      It’s believed DCR is used because the ‘nasolacrimal duct’ is very narrow and ‘probing’, etc leads to re-stenosis and the problem returns. However, if that’s what the patient wants to try as a conservative approach, they should be given that choice. A reduction is symptoms is better than nothing.

      My surgeon grabbed a piece of paper and said, “The location of the block maybe a stone and located here”. Later, with the subsequent scan, he was completely wrong and just guessing. In your case, the obstruction location doesn’t require a DCR at all. Depending on whether you are getting an external or endoscopic DCR…if they through the nose and cut through bone into your tear sac, the obstruction is still there. It’s only once, towards the END of the surgery they place a bicanicular tubing through your punctums and through the newly formed osteum – to ensure it won’t scar over and close. The tubing is removed in a few weeks (depending on your surgeon). It’s only once the tubing goes in, is when they push your obstruction out…how about that!!!! Why mess up your entire tear drainage system by cutting through bone and massacring your tear sac. You basically won’t have a tear sac after the surgery.

      I doubt your blockage is a malignancy, it’s a very unusual area for cancer growth.

      I still strongly advise AGAINST DCR regardless of how many oculoplastic surgeon’s recommend it. Find someone who’ll conform to what YOU want. I wish I had this perspective when I had the problem and saved me from a cascade of problems which I’m still dealing with several years later and have spent THOUSANDS on trying to reduce symptoms. I’ve literally flown all over the country for treatment to “resolve” the damage DCR has caused me. It’s your choice, your risk.

      Reply
      • Susan says:
        February 13, 2015 at 1:45 am

        George, your story for me is so timely. My surgery is scheduled for March 5th and I am canceling!!! Is the Jonas tube what you referring to? My story is this. I had thyroid inflation in 2003 as a result of an over active thyroid. Consequently not only was my thyroid oblated but salivary glands were damaged and my left eye began to tear. I did not initially attribute the procedure to these symptoms but as time progressed I began to suspect. Anyway, I, too. Had just an annoying tearing in my left eye. I saw my local opthamologist a few time and he advised me to see an eyelid specialist who would have a more sofisticated tool to open up my obviously blocked tear duct. I procrastinated for a year and then out of vanity ( my eye liner would be watered offby end of day) I proceeded to this ocular specialist. I told him Inwas there for him to unblock my test duct . He opened up a bag if tools and probed away . Then he described surgeries that probably would not be successful. . I wanted to run out the the door . They all sounded hopeless. Problem is he made my eye worse. It began tearing like a faucet. I called him to tell him he made it worse. He took no responsibility and prescribed steroid drops fir irritation. No help at all . He again said he did not make it worse and that it would go away in time. IAfter three months I saw another ocular specialidt. I told him my story do he gave me steroidsc and antibiotic. Two weeks later no better. He too said less is moreItceillmprobsbly go away on its own. That was the day before Thanksgiving. I decided To wait out another specialist until the Hlidsys were over. The last one I saw after NewYears did the test with syringe. I tasted thereafter in my throat but also water shot out at him do he said I needed the surgery. He said I had scarring probably from thyroid i
        Ovulation. I had to sign a release that he could proceed to Jonas tune if scar tissue would be too severe to warrant just the stenting. I have been calling the office with questions but have not heard from them. I have fily members who intuitively felt this surgery could be a mistake. I just happened across your story. Thank God!!!! I am not doing it. I cannot. The closer it gets, the more fearful I have become.I would rather have a hanky in hand than to have suffer as you are. I gave not had any infection or swelling. Only when Ivwas tryong out the steroids and antibiotic ointments. My eye looked smaller then too. Now it’s rely only the more advanced tearing that I am sure was the result of the firdt specialist probing away just becsusrIvssid I have a blocks tear duct. Do you have any suggestions ?

        Reply
        • George says:
          February 16, 2015 at 10:08 am

          Hi Susan, firstly, I’m very sorry to hear you’ve been so much of a roller coaster ride that seems to have no end. But I can assure you, it will get better!! Time is a great healer Susan and there are many solutions out there. Firstly, the “Jones tube” you mentioned are for people whom don’t have a “canaliculus” which is what drains the tears into the tear sac. Often it’s torn away in an accident or scar tissue can destroy it..many reasons. It could be the upper or lower canaliculus blocked, not working, or destroyed. What treatment did you have for your over active thyroid? How is it being treated now?
          If they managed to probe and use a syringe test on you, then your punctum and canaliculus is not blocked, thus I doubt you’ll need a Jones tube. You could have a blockage down lower in the naso-lacrimal duct. If you tasted some of the saline during the Syringe test then you possibly have a “partial block”…not a full block at all. A partial block responds well to balloon dilatation (read my blog further about that). When your doctor ran through treatments that won’t work it wouldn’t surprise me if he mentioned balloon dilatation and stenting. My answer to that is. “What about the doctors creed of FIRST DO NO HARM??” Shouldn’t we avoid an operation and try less invasive procedures first? Why throw a patient straight into the fire? Susan, be your own doctor and do some research, seek second and third opinions. Get a few more tests done and if it’s a confirmed blockage get an adult balloon dilatation. See how that goes. It should give you some excellent relief with NO side effects 🙂

          Keep well, and keep us informed.

          Reply
  13. Linda says:
    February 17, 2014 at 2:03 am

    I had the DCR surgery July 2013 stint removed my eye still watering. Have been given options of putting stint back in, removal of the tear duct completely I am terrified to do anything else this has been going on for 2 years.

    Reply
    • George says:
      February 17, 2014 at 4:17 pm

      Hi Linda, sorry to hear you still have tearing after the tubing removal. However, it’s not uncommon for the osteum to scar over again. You may be a very rapid healer and copious scar tissue developed around the osteum despite the tubing that was “supposed” to keep it open. In fact, a friend of mine has had THREE DCR surgeries on both eyes due to the tearing returning. In my opinion, if you’re a fast healer, why do the same thing twice, or even worse, a third time? The definition of insanity is repeatedly doing the same thing over and over again and obtaining the same unsatisfactory results.

      If you want a better result, CHANGE your strategy. Another DCR is about as silly as hitting your head against a brick wall. Rather, I have known many people with re-stenosis after DCR having a probing, balloon dilatation and a stent used. It was their surgeons option rather than doing another DCR. Smart doctors!! Unfortunately, they aren’t all smart, nor are they compassionate and “listen” to their patients. That’s where my oculoplastic surgeon went wrong. He didn’t LISTEN to me, when I told him I’m against surgery he dismissed it and rudely replied, “Well LIVE with it then”. He told me the same as all the rest, it’s the only way. But they are WRONG, totally and completely WRONG.

      My advice to you is to find an oculoplastic surgeon to use the non-invasive techniques of probing, balloon dilatation and stenting. These techniques do not permanently alter the structure of your anatomy at all. DCR leaves many structural changes that are permanently not reversible.

      Tearing is annoying, but it’s not as bad as the side effects from the DCR that I’ve experienced. Put up with the tearing whilst searching for the perfect surgeon, compassionate and willing to use the non-invasive techniques on you. They are out there. Good luck!

      Reply
  14. Trinette says:
    March 14, 2014 at 4:43 am

    I now have the white/yellowish discharge from my tear duct area. Although, my tube was never removed, is that not obvious that there is an infection? Mine drain so bad that my eye is swollen and glued shut every morning. Every morning the swelling gets worse. My suegery is 12 days away! I going to look like I’ve gotten in the ring with Holyfield by the time they take it out. I can’t take the pain that comes along. So is that drainage called dry eye?

    Reply
  15. Elizabeth Schneider says:
    March 28, 2014 at 7:15 am

    Your story is exactly why I won’t go through with the surgery. I did have the procedure where they put in the silicone stent through the two tear ducts and down into the nose. I had horrible discomfort from the stent and was initially dismissed. I continued to complain about it and they finally took a look (how hard was that to do?!). Turns out there was a kink in the stent that was causing the irritation. The doctor was not at all surprised it was painful. He was willing to take it out right there and then, but that would mean I went through all of that for nothing. I managed to suffer through it for another month. Turns out all that did nothing. My eye was as watery as ever. My only option was DCR.

    I have read several accounts of peoples DCR procedures and none of them mention a Jones Tube. Is it just understood that a Jones Tube was used or are some surgeons using something else?

    Reply
    • George says:
      March 28, 2014 at 9:30 am

      Hi Elizabeth, sorry to hear the stenting didn’t go well. If there was a kink in the stent, then the problem lays more with the material the stent was made from and the surgeons technique upon placement.
      A Jones Tube is not used during DCR. A Jones Tube is used to create a new canaliculus for those that don’t have one, thus is inserted permanently. During DCR the tubing they use is called a “bi-canicular” tube and remains in place temporarily to keep the newly create hole in the nose (or new artificial tear drainage pathway) open.

      Reply
  16. Darlene says:
    April 17, 2014 at 2:54 pm

    Hi George

    I am a 55 year old female and my tearing started in Oct 2013 with an abcess that developed, because at the time the Dr. told me that it was only allergies and prescribed nothing. I had FML drops on hand from a previous eye problem and began using those. I have seen two tear duct specialists.The first one flushed my eye out and prescribed antibiotic drops along with the FML. Until two weeks ago things seemed ok. Then I started having tearing again. Puffiness in the corner. I started back on both drops and made an appt with another Dr. since the last time I saw the first one…told me that the next step would be surgery. The one yesterday refused to do the X-ray as she stated that it would not change the way she would do anything, which is in her opinion the DCR surgery. I begged for alternatives and she kept shaking her head no. She syringed my eye not forcefully as the first tear duct specialist. Nothing went in my throat, but shot back out the top of my eye, so she says. She said she would not do the probing because it would only grow back. I just want relief even if for just a few months. I refuse to do the DCR surgery. I am so afraid. I made an appt for the 30th of April with the first dr. again for a probing. I am not sure if he will refuse to do that, but we shall see. Thanks for your story. I still feel hopeless.

    Reply
    • George says:
      April 18, 2014 at 3:08 am

      Hi Darlene,I’m sorry you are clashing against hard headed ophthalmologists. It’s an all too familiar situation. It can be difficult to find someone to use probing, balloon dilatation and/or stenting. I recommend you obtain a list of ophthalmologists and oculoplastic surgeons from the association and “call them all”. Ask if the surgeon performs the X-ray and if he/she will do adult probing and balloon dilation. Call about 20 and you’ll be sure to find someone positive, who serves the patients concerns rather than follow robotic principles of how leaky eye should be treated. Good luck and please keep us informed.

      Reply
  17. Paula says:
    June 12, 2014 at 11:17 am

    Has anyone tried a more natural route to unclogg tear duct like accupuncture and tear duct massage. I too have blocked tear duct. Right away the doctor wanted to do a DCR. That decision was made after a tear duct probing of tear duct. I went home did some reasearch and the surgery seemed excessive and frightening. Needless to say i am choosing not to get the DCR. I have schedule a doctor appt. with my GP to see if he knows a doctor who will view the DCR surgery as a last resort after everything else has been tried. Im not a big fan of a doctor pushing me into a surgery that may or maynot work. I am young and only 39. Any thoughts id like to hear them. Right now i am getting accupuncture to get my sinuses to drain and open as well as messaging my tear ducts in the morning shower and at night before bed. Ill update when my doctor referers me to a new doctor. Blessing to all.

    Reply
    • George says:
      June 14, 2014 at 4:46 pm

      Hi Paula, I’m pleased you aren’t going ahead with DCR. I’m a big believer in accupuncture and recall reading some research on it unblocking the tear duct. I had accupuncture “after” my DCR for pain form the induced dry eye and stress. It worked very well. You need to find someone very good. All the best with it.

      Reply
  18. Darlene says:
    June 14, 2014 at 6:01 pm

    George thank you for your response from my post in April. I am still battling the eye problem. It does appear to be blocked at least 90 percent. I have been referred to another Dr who I am told will do the X-ray. I am not sure if he will do the probing. I remember having that done in Oct. 2013 and I was fine for many months. My eye with the use of antibiotics daily and sometimes steroids does ok during the day. After sleeping …it is much worse in the morning. Anyway my appointment is July 11th. If I get the same surgery speech…I will be back here for support. Thanks to you and all who contribute to this blog. I may try accupuncture at a later date. Hope you are well George. It is very unselfish of you to spend your time talking to others when you still may be suffering yourself.

    Reply
    • George says:
      June 17, 2014 at 12:00 pm

      You’re welcome Darlene. Good luck on June 11th, please do report back here and let us all know how the appointment proceeded. The non-invasive techniques such as balloon dilatation work very well for partially blocked ducts. Probing often does provide relief for a few months and then it re-stenosis again so perhaps a balloon dilation, followed by a stent in the same procedure will work very well for you? Push for it, and don’t ever give in to allowing an eye surgeon talk you into a DCR. They can be very forceful about it and almost push you to the receptionists office to book in for the procedure before you’ve even agreed.

      Reply
  19. Darlene Moore says:
    June 30, 2014 at 7:38 pm

    Thanks George for your quick response. It seems like the 11th of June is taking forever. I have developed a stye on the same eye which has added to the misery. I was reading your response about probing causing re-stenosis. It seems to me like I would rather do that every few months and have relief than to go through this tearing and redness for so long. I just don’t really want to be sedated. I am just afraid of that. I still think it is better to do an x-ray so they can see exactly where the blockage is before they do anything. Do you by any chance know what the blockage actually is? If it is mucous that has hardened, I don’t understand why a good probing does not help get rid of that. I am sorry to bother you again….these last few days have been terrible. Hope you are doing well. Thanks

    Reply
    • George says:
      July 1, 2014 at 3:05 pm

      Hi Darlene,
      There’s many reasons why probing leads to re-stenosis. But it’s ability to block up again can be prevented with anti-inflammatories, anti-fibrotics and they just don’t seem to use them. I agree with you, I’d rather have probing every few months for the relief, in fact, what if it provides enough relief that it’s better than before, and you can live with it? After all, a DCR totally obliterates the tearing, who says we want that as a goal? What’s wrong with simply a “reduction” in tearing via a less invasive procedure? Living with the opposite problem (dry eye) induced by DCR is far worse and dangerous than a few feeble tears rolling down the cheeks once in a while. I’d give my left arm to have my tearing eye back again!!

      The blockage is caused by scar tissue forming, it’s also caused by ‘dry eyes’ which leads to ‘dry’ naso-lacrimal ducts causing them to shrivel and shrink from the lack of moisture. Infections are also known to cause blockage through inflammatory mediators leading to scarring, etc. It’s a monopoly. The reason behind the blockage isn’t as important than simply having it removed.

      Oculoplastic surgeons believe probing doesn’t work because the naso-lacrimal duct is a long and tiny tube that drains tears. It’s surrounded by bone and thus probing can easily “miss” any curvatures and break through the delicate tissue and hit the nearby bone. That’s fair enough, but if the patient wants that procedure why deny them? what is the harm in it? I’m totally lost as to why MOST of them refuse to do it when it should be STANDARD procedure. Going straight to DCR is ignoring the doctors creed of “First do no harm”.

      Reply
      • Darlene Moore says:
        July 24, 2014 at 12:29 am

        George,

        My original appointment on June 11 with the new Dr. was cancelled until today. I will get to how that went in a moment. I have been using the FML and the antibiotic drops due to the stye. It finally cleared up around the 4th of July and it seemed like the tearing stopped for most of the days until late evenings. I saw your post to Paula about Accupunture and decided to seek that out in the meantime. I found this very compassionate Chinese lady who works as an Accupuncturist here in the area. I saw her twice. It seemed like after each visit, it got worse just for a day or so. But then a week after my second appt. ( I went two weeks in a row) on the 8th of July my eye cleared up almost to the point that I would have never known it ever had a problem. I am not saying it was anything she did because when the stye came, I decided I wasn’t going back. But from the 8th of July until yesterday I was mostly symptom free. So I will go back to her again tomorrow, since I am having some tearing again. Last time that an eye Dr. syringed my eye, it did not drain in my nose or throat at all.
        Now for today’s visit….The doctor I saw today was the most arrogant, cocky physician I have ever met. Without going in to details… it ended up with him answering my request for the X-ray to there will not be an X-ray because I am refusing surgery, so no need to know where the blockage is. However when he syringed it, I felt quite a bit go down my throat and nose. He said that it was partially blocked. I can’t understand if it is blocked, how does it become unblocked? Anyway, he said balloon surgery only works on babies because our bone is too hard. Probing is dangerous and that I needed to stop using the antibiotic drops and the FML. He said don’t worry about tomorrow, just come back if you ever need me. Since it is not really bothering you a lot now, just don’t do anything. It was really a weird and useless visit. So once again, I come home very discouraged. I will continue with the Accupuncturist to see if there is still improvement. I don’t know what else to do. Just feeling hopeless. I know the drops ( I saw your statement on the preservative in FML) are bad but I don’t want to have a puffy eye all the time. I use them only before bed. Thanks again for listening. Oh, I forgot to mention to you in the beginning that I was diagnosed back in 2006 or 2007 with dry eyes. I had the little plugs inserted 3 different times and they always seemed to disappear. Anyway, thanks again George for your time. I will continue to read your blog and hope that someone will have some insight. I live in SC and no one in my town will work with me or in the NC area that I was at today. I try to be thankful that I can see…which I am very thankful. It is very hard explaining to co-workers, friends and family how a teary eye can change your life a bit. From listening to you, I see that a dry eye can change your life as well. Take care.

        Reply
        • George says:
          July 24, 2014 at 1:28 am

          Hi Darlene thanks for filling us in with what’s been occurring. The acupuncture seems to have done “something” if you can feel some saline in your throat after syringing, though weren’t you diagnosed with a partial blockage in the past?

          I’m not at all surprised with that arrogant doctor you saw. How rude indeed to dismiss you so quickly. They all seem to say balloon dilatation is only done on babies. No it’s not!! There are surgeons out there willing to use balloon dilatation especially on a “partially” blocked NLD since it yields better outcomes. You are a prime candidate for the procedure that could very well be life changing at this point. You may have to do some travelling for the procedure and meanwhile research the closest to you whom uses balloon dilatation on adults. Simply phone around, send emails to every known ophthalmologist and oculoplastic surgeon in your state and adjoining states. That’s what I did, and it uncovered a few very compassionate doctors who would do anything to assist. But I’m in Australia. However, I’d encourage you to do the same, it takes time, but it’s the only way.

          You keep swelling and having to use FML because the constant flood of water is the perfect breeding ground for bacteria and thus your body recruits inflammatory mediators to deal with the situation. FML treats the symptoms, reducing the water through a non-invasive procedure such as balloon dilatation or stenting is treating the cause.

          I also don’t agree with that arrogant doctor that probing is dangerous. Perhaps it’s dangerous if the doctor is not competent with the procedure?

          Good luck, keep fighting to seek better help and care!

          Reply
  20. Theresa says:
    August 7, 2014 at 2:46 am

    Since you seem to be thoroughly informed in all of this I would love your input. My 5 year old woke up with a swollen eye over a month ago. It progressively got worse for about 5 days then finally the antibiotics began working and over about 7 days it slowly went down. Eventually I noticed a large hard lump under his eye near his nose. We went back to doctor and were referred to ophthalmologist. He was unsure what it was and sent us for an MRI. Called us 3 days later with more concerns and referred us to a lacrimal system specialist. By this time the lump is getting smaller day by day but is not gone. We went this past Monday to the new doctor and she said my son needs an external dcr…that he has a birth defect that is now presenting itself. That it’s our choice but the eye will continue to have swelling and infection bc of the issue. We said ok we would call and schedule. Well then I got home and started reading…about the scar, the cutting of the bone, the stint stuff. I’m very confused and concerned. My biggest confusion is that my son has NO problem with excess tearing…never has. How can it be blocked or whatever if his tears are going somewhere?! I’m not at all sure what the right answer is. I’m fearful of the next eye infection being worse…this one was very resistant to antibiotics. I’m more fearful of the surgery. She made it sound like no big deal but it seems invasive to me. And I actually really liked her but now that I’ve read up on it I feel misled or under informed. Any input is appreciated. Thank you.

    Reply
  21. Philip Rhoades says:
    September 2, 2014 at 8:15 am

    George, People,

    Just like “Bones” on the original Star Trek used to say, surgery in our time is very primitive. I was diagnosed with “Dry Eye Syndrome” more than ten years ago and the tearing up has gradually been getting worse – now the blockage is 100% in the right eye and only a little better in the left. I have been looking at all the options for “fixes” for a few years now and I have come to the conclusion that none of them are completely satisfactory. I believe this particular condition probably won’t be able to be fixed cleanly and simply until there is some form of nano-tech solution ie microscopic “cleaning” machines that can be syringed into the duct and can clear the blockage and scarring and re-open the natural ducting. Unfortunately this solution is not on even on the horizon yet so I am still left considering the currently available options.

    George, I am in Sydney – do you have recommendations for people here?

    Regards,
    Phil.

    Reply
    • George says:
      September 2, 2014 at 10:45 am

      Hi Phillip,
      Nano technology will occur in the future, I’m sure, but not in our lifetimes!! I can recommend an excellent optometrist who treats dry eyes in Sydney. Or were you looking for a surgeon to remove the blockage without DCR surgery? Thanks.

      Reply
  22. Maree says:
    October 22, 2014 at 3:43 am

    Thank you so much I was about to book in for the surgery somewhat reluctantly as I have never been in hospital or had surgery in my life and I am 48. I am definitely going to put up with my watery eye. I wear contacts at work and to have a dry eye as a result of surgery would be a disaster and I think I would not be able to work.

    You have done me and others a great service.

    I feel for you, I hope you can find some relief in future from your condition.

    Take Care

    Maree

    Reply
  23. Lucy says:
    November 15, 2014 at 12:57 am

    I live in NE Ohio. Had to be hospitalized for two days/nights early Sept. 2014 for severe, acute dacrocystitis that was not responding to Amoxycillin/Augmenting. They put me on vancomycin, pepperocillin (sp?) bactrim, and let me go. I then had to take clindamycin for 10 days. It came back a few weeks later, and they put me on Cephalexon/Keflex. Ocular plastics surgeon is ONLY recommending DCR. I read ALL of your story and everyone’s posts. At this writing, the nasolacrimal sac on my R eye is over the size of a peanut (shelled, of course), very red, and the red streak is coming back. The first time I presented in August 2014, saw a Nurse Practitioner, who dismissed my three attempts to explain that something felt wrong with a duct or something, in the corner. There was no redness or swelling. NP sent me home w/ nasal allergy Flonase prescription. I was working in home care with a very sick, older woman who’d been in a dirty facility weeks earlier, and believe that’s where I then picked up a horrible staph infection that led to my hospitalization. Now, on SIXTH antibiotic: doxycycline. Not one to take antibiotics, and not one to rush into surgery, I’ve put if off, and talked to my sister, an RN, who also believes I should wait. This infection is scary when it flares up. I look hideous. HIDEOUS! I’m afraid that if I don’t get the DCR, I will get so sick, the infection will go systemic and I’ll get septisemia or something life threatening. I’m also afraid of surgery complications and invasiveness. B/c I put off surgery now for over a month — ocular plastics surgeon is only avail. one day a month at Cleveland MetroGeneral Hosp. — I will have to wait until February 2015, IF I decide to get it done. So very many things and details I’m afraid to leave out of my story. Three weeks ago, Oct. 23, I went in for second visit to surgeon, to ask questions and express concerns. It wasn’t until after hemming and hawwing a lot, I then asked if he’d make a small incision to get enough fluid to culture the nasolacrimal infected sac. He injected me with at least one lidocaine doses, then got the culture. It came back as s. aureus — staph. I pushed to get a copy of the results. I will be contacting the Cleve. Clinic to find out whether any docs there will do balloon dilation AND stenting on this adult of 53 years. Thank you for sharing your story.

    Reply
    • George says:
      November 15, 2014 at 5:56 am

      Hi Lucy, sorry to hear about the dacrocystitis and I certainly do know how it looks when it’s flared up. You didn’t mention if you have a tearing eye. Do you have a blocked naso-lacrimal duct? Usually, what causes dacrocystitis is a blocked duct that causes a tearing eye and a subsequent full tear sac where the tears have no where to go. It becomes like a pond, no fresh water getting in and bacteria accumulates and putrefies. If the naso-lacrimal duct is opened via balloon dilatation, suddenly the pond and it’s bacteria are flushed out with fresh water (tears) replacing it. DCR does the same thing, it simply is more invasive and rather than going through the natural opening of the naso-lacrimal duct, a hole is drilled into the nasal bone and an artificial passage way is created where the tear sac is drained into.
      Dacrocystitis is a dangerous condition and if left untreated will get worse. It’s a matter of weighing up the odds with the severity of the problem. I know you seem to be caught between a rock and a hard place, but in this case, DCR might actually be your only option. I don’t want to advise against it, and meanwhile, the infected tear sac is getting worse and could lead to further problems. Perhaps pursue and DEMAND balloon dilation and stenting and if necessary seek other oculoplastic surgeons out. I recommend phoning their office and asking the receptionist if their surgeon will perform balloon dilatation/stenting on an adult patient. Some of them don’t want to lose business and will agree. This will save you a lot of money and travelling around to useless appointments that get you no where. I understand it also depends on your finances and time. All these factors need to be considered with your decision. Good luck and please keep us informed with your progress.

      Reply
    • angela says:
      December 8, 2014 at 3:07 am

      I had extremely dry eyes, after seeing a few specialists and being told I needed puntal plugs I had them put in only to have them fall out over and over. My last ophthalmologist pushed them below the tear duct line causing the tear duct area to become infected. I felt the infection (a very small little ball) immediately. Went back, told there was nothing wrong. After a week and severe pain and several trips back to an ophthalmologist and more meds I developed a tumor around the plug and needed emergency surgery. Which was done by Dr Perry at the cole eye center in Cleveland. They had to create new tear ducts and put in a tube through both tear ducts. The tubes were irritating and painful and had to stay in for 6 months. My eyes were not circulating very well and got infected again. This time I couldn’t get a hold of my eye Dr at the cole eye center and the Dr on call couldn’t help me this was over his head. I became serverly infected required IV meds and another surgery. I just had my 5th surgery this year on my eyes this time it was a DCR with a crawford tube. This was my only surgery so far that did much of anything. But this time I went to Dr Levine in Loraine OH and he by far was far better than Perry. Kostin in fairy new and in time he might be pretty good as well. I guess what I am saying is that no matter how great they tell you they are make sure you feel you are in good hands. I would recommend Dr Kellis in Chardon or Levine in Avon or Loraine he has two locations. Both Drs had to treat me as an emergency and sadly I have to have yet another surgery because I am having an allergic reaction to the antiscaring meds and it swelled off my new tear ducts. But this isn’t anyone’s fault. Just take your time with your decision. Best wishes, hope your story is better than mine.

      Reply
    • Julia says:
      December 17, 2014 at 9:45 pm

      Your story sounds similar to my own, I was getting very bad infections for 6 months and DCR was the only choice for me. I am pleased to say that it was the right choice for me and my problems are gone now. I sympathize with everyone who has had DCR for mild problems and then experienced long term side effects, but for some of us (especially those who are getting severe infections) it is the right choice. You can ready my story here:

      http://myblockedtearductsurgery.wordpress.com/

      Reply
  24. michele watson says:
    November 19, 2014 at 6:09 am

    So glad I read this. Today I saw a second opthalmologist in Perth – only offered surgery s option for a watery left eye – blocked duct. Nothing else. Told it seldom reverses. It started 3 months ago- basically when I commenced HRT for the first time. hey wanted to do the op next week but am cancelling it. The flushing didnt not work today – mind you it was damn painful! No pressure from syringe but a sharp pain as saline flushed through. I came home and researched other options. I will treat myself – off to get an anti-inflammatory and antibiotic eyedrops (probably need a doctor-more money to prescribe!). I am so against impulsive decisions to operate – my mother died after being scared into an immediate bypass through a medical mistake. I am also going to keep up with gentle massage and warm compresses. Any other ideas? The specialist said today the op is under full anaesthesia and no guarantees! Its so frustrating – am having similar issues re HRT – you take your chances but it seems doctors dont care anymore re providing real information and alternatives. Thank God for Google!

    Reply
    • George says:
      November 19, 2014 at 2:01 pm

      Hi Michele, thanks for posting. I can tell you know you’ve made the right decision. I’m glad my website was able to show you the stark ‘possible’ consequences of DCR, an operation they consider very safe. I recall when I had a watery eye, using an over the counter antibiotic (Bleph10) helped as well as antihistamine drops. Continue with the warm compresses and squeeze the tear sac to keep it empty. Putting a thin layer of vaseline near the lower eyelid will prevent tears rolling down your face. Best of luck!

      Reply
  25. angela says:
    December 8, 2014 at 3:15 am

    This story is so unfortunate and sad that they must feel that leaving out some information to speed things up a little at your appointment is acceptable. I never wanted surgery either and with my eyes being so infected I had no choice. I wish I never let them put plugs in my eyes because that is where my nightmare began. Your eyes are so important that you really can’t afford to have someone not take the full time with you to explain every risk. I came across your site trying to see if anyone else has gotten an allergic reaction to the tube material. I am super sensitive to it and they keep it in my eyes and about three months into recovery my eyes reject the material form tumors and require another surgery. Yet they never listen to me and just remove the tubes early. so many complications. I hope you find what helps you and all this is just a bad dream but I think you and I are in for a mess of another never ending nightmare. Good Luck to you. Thanks for the post. People should know what you never had a chance to.

    Reply
  26. Helen says:
    December 10, 2014 at 1:50 pm

    Hi George. Just to keep a little balance…mine is a success story for DCR. I had suffered from watering of my right eye for nearly a year and apart from the inconvenience, it affected my vision and made it difficult to work. I tried hot compresses, massaging, ignoring it, wiping it etc etc. I then saw an opthalmologist who attemped to syringe it but to no avail and he referred me to a surgeon. I was pretty sick of it by now and just wanted it fixed once and for all. The surgeon also attempted syringing but this time he used quite a lot of force (which was momentarily painful) and this time I definitely felt a gush of saline at the back of my nose. He gave me the FML drops and told me to use them until they were finished and said that with a bit of luck, possibly things might be better. He offered me the opportunity to call him if I wanted to arrange for DCR surgery. He explained very concisely how it worked and all the risks but no pressure from him at all to have it done. After one blissful week of being free from watering, it came back with a vengeance.

    I booked myself in and had the surgery 2 weeks ago. There was no post op bleeding from my nose or pain and I didn’t take any time off work apart from the day that I had it done. The tube comes out in 2 weeks from today. My eye is back to normal with no watering or dryness. Maybe I was lucky but I wouldn’t hesitate to have it done again if the other eye started to water. I am 67 years old and very happy with the results.

    Reply
    • George says:
      December 10, 2014 at 2:24 pm

      Hi Helen, thanks for writing in. I’m glad everything is going well for you to date. In fact, I was also going well with my DCR whilst the tubing was in place. My problems occurred when the tubing was removed and that eye became extremely dry. I’m wishing you all the best with the rest of your recovery.

      Reply
      • Helen says:
        May 29, 2015 at 4:15 pm

        Hi George…just to follow up….I had the tube removed on December 23rd 2014. Now, at June 29th 2015, six months later, I can report that the watering has not returned and the surgery has been a total success. I’ve forgotten how awful a watery eye can be.
        I would like to add that most surgery looks pretty gruesome when viewed on youtube etc and I would recommend that anyone considering an operation of any kind, should stay away from watching the proposed surgery online. I’m not saying that we shouldn’t investigate and educate ourselves because knowledge is power but NEVER watch the surgery on video. No good will come of it and it just creates anxiety. That’s my opinion for what it’s worth. All the best to everyone on here with a watery eye:-)

        Reply
  27. Lee Goodchild says:
    February 19, 2015 at 8:06 am

    Thabnkyou for your article which I found so interesting just having been diagnosed with a blocked tear duct. I am just going to put up with it for the time being, horrified by your story. However I will certainly refer to it and to the comments from your readers before taking a further step.
    Warm regards

    Reply
  28. Helaine says:
    April 29, 2015 at 6:27 pm

    I have been diagnosed with a lower blocked tear duct in my right eye.
    I went to Dr. Arthurs, an ocular surgeon at the Montreal General Hospital in Montreal Canada.
    he tried the saline test and said the lower duct was blocked, and therefore DCR surgery was required.
    he said the blockage was not near the end, but near the middle, making it a more difficult surgery, and he would probably need to use a lester jones tube (glass) rather than a silicon tube, and if a lester jones tube was used, it would have to stay in permanently. he also said they would have to break an orbital bone on the side of my nose, and there would be a scar and bleeding.
    I have also read online that this tube requires maintenance, such as saline drops everyday and keeping it clean, and that sometimes this tube falls out.
    I don’t want this surgery, but sick of the tearing all the time in 1 eye.
    I’m scared and very concerned not knowing what to do.
    can you explain to me what balloon dilatation and stenting are?
    I would like a 2nd opinion.
    I’m a 62 year old woman and I wear contacs. it’s really a hassle to try to blot tears below the bottom of my contact lens.
    I need help but don’t know who in Montreal deals with this without the DCR surgery.
    I can also tell you that I watched the DCR surgery on YOU TUBE, and now for sure after watching that, there’s NO WAY I’M DOING THE SURGERY!
    there has to be an alternative.!

    Reply
    • George says:
      May 1, 2015 at 1:36 am

      Hi Helaine,
      I’m sorry to hear that you’ve found yourself here with epiphora. How was the eye doctor able to determine the block was ‘near the middle’ without an X-ray (specifically a special X-ray called a macrodacrocystogram)? Without the X-ray he is only assuming without any accuracy. I would suggest you demand the X-ray and most blockages are at the distal end of the nasolacrimal duct. Thus you may not require a Lester Jones Tube at all…so rule that out first.

      A Lester Jones Tube is only required if the block is in the canaliculus (from the corner of the eye to the tear sac) and that is less common. Let’s not jump to any conclusions about where your blockage is until it’s determined by an X-ray.

      The balloon dilatation and stenting are for blockages in the nasolacrimal duct. Balloon dilation is a probe that is pushed through the blockage then inflated to push the remnants of the blockage to the side, creating a patent tube. However, it’s not determined how long it will remain patent, it could block again.However if you had a stent placed in there instead then it’s going to be patent the entire time. The only problems with stenting could be a physical sensation of feeling it in your nose, possible blockage within the stent itself and worst case scenario – infection. However, they are only mild nuisances and may not occur at all. The stent is safe and can be removed at any time. I certainly would have preferred to have tried this option before DCR but never got the chance too. Thus I encourage everyone in this predicament to find someone who will use a stent. Not many use it and they’ll tell you it doesn’t work. But studies reveal the opposite, it’s successful up to and over 60% of the time. In fact, they give a 90% success rate with DCR but look at what they do to you!! and if you read the many comments and feedback on this site DCR doesn’t always work and tearing continues. The most challenging part is locating an eye doctor who performs these non-invasive techniques. You could try contacting LacriCath here..

      http://www.questmedical.com/products/ophthalmology/a-non-surgical-treatment-for-blocked-tear-ducts-and-chronic-tearing.aspx

      … enquire who they supply their LaciCath too.

      So my advice is to get a macrodacrocystogram to locate the position of the block. If it’s in the nasolacrimal duct find an ophthalmologist to perform adult balloon dilation and/or stenting.

      Please keep us informed with your progress. Good luck!!

      Reply
  29. Brent says:
    June 20, 2015 at 7:35 am

    Hi George

    I have a blocked tear duct (Nasolacrimal Duct Obstruction) which resulted from a viral conjunctivitis I had in May 2014 for the first time and now very severely suffer from epiphora (excessive tearing) on my left eye.

    It is extremely uncomfortable where I cant work anymore nor can I socialise or play sports. Its there all the time.

    I have seen all up about 5 or 6 different eye specialists including few surgeons as well. Most of the specialists treated the symptoms and charged me roughly around $250 to $300 every time. The surgeons definitely and clearly indicated that I need a DCR surgery otherwise I will be suffering for many years to come and that I will never ever have any relief from epiphora unless I go ahead with the surgery.

    They also said balloon dilatation and stenting or other alternatives are not an option because my duct is fully blocked not partially as it was once when I was probed to see.

    Im not really sure what to do after reading many reviews about DCR surgeries and your website being one of them. I cant leave it the way it is now because its too hard to deal with it everyday. Its a challenge every moment. I cant work as I said as I cant afford to wipe it away every few minutes in front of people not to mention how annoying it is to do it. I cant socialise for the same reason. I cant exercise and so forth. Plus my vision becomes blurry to be able to do those things.

    The surgeons mentioned the public system waiting list is 2 years and if I go private its 2 months of waiting for the cost of $2000 to $2500 for the DCR surgery. However, the question that I cant find an answer to is will I be better off after the surgery or am I better off with how it is at the moment which isnt nice at all. Not sure what to do. Its changed my life so much that I cant explain.

    I have also consulted a Naturopath to treat blockages generally in the body and was advised that I need to take 2 different drops orally and drink a special vegetable mix for 3 to 4 months before I can see any sign of relief with my tear duct blockage. I tried for few weeks after paying few hundred dollars for this remedy type but then lost hope and gave it up where I didnt believe it would work.

    I contacted a Acupuncture and Traditional Chinese Herbal Medicine place and they said they could open it up in with acupuncture and herbal treatment which will go for few months at least. I didnt feel optimistic about this treatment type either and decided not to try it. It would have cost me under half a grand this one.

    I just dont know what to do and where to go anymore. By the way Im from Australia.

    Do you think I should have the surgery and see what happens and live with the consequences either way OR leave it for some more time wait to see if it goes away naturally which is not an option according to medical people ?

    If I was to have the surgery do you think I will face more or additional problems and regret having the surgery ?

    I desperately need guidance with this problem and have concerns about how ethical and honest medical people are.

    If I was a immediate family member of one of the surgeons like a son or a brother then do you think they would have still decided on DCR surgery without trying other alternatives like balloon dilatation or stenting or others that I dont and wouldnt know about ?

    I just need more honesty and some surgeon to say to me if my son or brother was in your situation I swear / promise I would recommend the same treatment / surgery.

    And are there things like complications that I should know about to help me better decide to go ahead with the surgery or not. After all I should decide whats best for me before anyone else. Thats all I want to know about.

    Thanks for taking the time to read my letter and hope to read your opinion on my story soon George.

    Regards

    Brent

    Reply
    • George says:
      June 20, 2015 at 10:32 am

      Hi Brent,
      Thank-you for your detailed description. I can see the dilemma you’re in and torn between decisions.To have DCR or not? How old are you? Did you ever have a problem with dry eyes prior to the viral conjunctivitis episode? Do you have epiphora in both eyes?
      I understand how difficult it is to find an ENT to perform the lesser invasive techniques and they always tell you it doesn’t work, especially if you have a FULL block. What if you found someone to try balloon dilatation and stenting on you?…and find that it does provide some relief? Would that percentage of relief be enough? What if it reverts back to the current severity? Well, if it doesn’t work at least you have peace of mind knowing you’ve tried. Then, on that basis, would you feel more comfortable having the DCR then? knowing it’s the absolute last resort?
      I need to contact every ENT, ophthalmologist and oculoplastic surgeon in Australia and find a few whom will perform these non-invasive techniques. Especially, a ‘private patient’ should have more choices at hand. I do not have a list at present and will endeavor to provide a list for this site towards the end of 2015.
      In terms of being aware of risks and complications – please refer to this website for a detailed list. These are not the complications your surgeon will provide you. In fact, you’ll be told about bleeding, bruising and possibility of it not working…but nothing about the REAL long term possible permanent complications. Perhaps they see them as rare? Maybe they are and could you really be that unlucky? Yes it’s your own decision and you have to weigh the odds of living with serious epiphora or risking surgery. It seems your epiphora is interfering with your life to an extent you cannot LIVE it, so the writing is on the wall….
      …just a word on complications…it IS possible to overcome or learn to live with them. I experienced an annoying “blowing of air” onto my eyeball (after DCR) when breathing as a complication (that occurs in up to 20% of cases) and after a few years it’s significantly reduced. The body can heal itself given the right conditions, patience and knowledge.

      I can understand your hesitation and I’d be the last person to recommend DCR…but who knows? You could jump into it and be absolutely fine afterwards!!

      Let us know what you decide to do and please keep us updated with your progress.

      Reply
      • Brent says:
        June 20, 2015 at 11:12 am

        Hi again George,

        Thanks for the reply.

        Im 40 years old. I have never had dry eyes or had any eye problems. My tearing is just on the left eye.

        I have found one surgeon who does balloon dilatation for LacriCath. However, Im not sure if I would be a good candidate for it as I was told balloon dilatation nor stenting is an option for me.

        Im not sure how they can tell as Ive never had an X-Ray of it except for probing and nasal check to see if im suitable for Endoscopic DCR and I was told I can have that instead of External DCR.

        Also to relieve the symptoms of redness, burning sensation and itchiness would you recommend anything like drops or antibiotics and etc ? Some days it just burns a lot as I suspect there could be some infection present on my left eye.

        You mentioned about air blowing on the eyeball after the DCR. Is that so uncomfortable or is it bearable still ?

        Are there any people that you know or heard of who had success with the DCR surgery without any complications and were better off without a doubt after it ?

        Is it really 90 % success as opposed to 10 % not (as they say) or 50 % 50 % as I gather after what Ive been reading where it could go either way.

        I will let you know how I go.

        Thanks

        Reply
        • Helen says:
          July 31, 2015 at 2:48 pm

          Hi Brent

          I live in Australia too…in Perth.

          I had a sucessful endoscopic DCR…read my two accounts above (December 10th 2014 and May 29th 2015) as they may help you to decide. I have to say that I find this site depressingly negative about doctors and surgeons. Surely they are not all money-hungry charlatans? I posted my positive experiences to try to add a bit of balance but everyone seems to want to dwell on the bad stuff.

          Good Luck…at least a watery eye isn’t terminal….there’s a lot worse things to have:-)

          Kind Regards

          Helen

          Reply
      • Brent says:
        June 21, 2015 at 9:11 am

        Hi George,

        I will try to see if a doctor would do a balloon dilatation on me or a decent forced probing. And yes my blockage is at the distal end of the nasolacrimal duct as I was told and confirmed by specialists and surgeons.

        I got probed twice and there was some sign of relief but didnt last for more than few days. However I dont think the injection or the needle was push thru deep in or long down enough to pierce or pop anything if you know what I mean. Do you think this could be a tactic to convince and push people thru to surgery instead for profit reasons ? And when you say “Probing the Block ” is that going to be a permanent fix and can it be done on full blockages like mine do you think ?

        Did you have the External DCR and is that why air was coming up at the corner of your eye ? Would Air Regurgitation still happen with Endoscopic DCR ?

        Have you come across anyone so far who had success with NON INVASIVE treatments in any form with Nasolacrimal Duct Blockage ? Do you think this treatment exists but is hidden from people for reasons such as making more profit like $2500 for surgery or $250 for probing or similar NON INVASIVE treatments ?

        Thanks again George.

        I will try to copy and paste this as you advised which makes sense for people to read and gain experience from.

        Regards

        Brent

        Reply
    • Craig Smith says:
      November 26, 2015 at 4:21 am

      Hello Brent from a fellow Aussie.
      I’m in a similar boat. I had annoying blocked tear ducts and decided on the surgery. This was internal and cost about $3200, of which I got half back through my private health fund. To cut a long story, it didn’t work cause I could not tolerate the thin tubes he inserted. The eyes ended up way worse than they were to start with. I had surgery again and again could not tolerate the tubes. Eyes still bad. So now I am having the surgery a third time -yikes ! – and will simply man up and put up with the tubes for the required 6 weeks. I started a new job in Feb this year – a hectic teaching position at a University -and had the first surgery in June. This ordeal has greatly impacted on my ability to focus on work. I lurch from weekend to weekend. I’ts now the end of November and I’m having the third surgery in mid January and praying that it works. Despite my experience, I would advise the surgery for you, since you have nothing to lose. Craig. Melbourne.

      Reply
  30. Madhavi says:
    June 27, 2015 at 4:01 am

    Thanks to share information.
    I have suffered for the years with this tears in my left eye. At last I have undergone for the DCR and doctor charged me heavily. But unfortunately I haven’t get any relief, still I am suffering a lot. There is no use in visiting these doctors I hate all of them. I met many doctors since long time, but I am not satisfied and no one suggested me better options. So I gave up and started living with this problem. It effects my performance a lot in my profession and all aspects in my life. I don’t see any solution for this problem.

    Thanks to you all
    sri

    Reply
    • George says:
      June 27, 2015 at 4:58 am

      Hi Madhavi, Did you recieve an external DCR?…do you have a cut on the side of your nose near your eye? I have heard quiet a few people say it’s the ‘LEFT’ eye that was watering. I wonder if there’s something to do with the anatomy of the left eye that creates a blockage in the naso-lacrimal duct? Perhaps an ECP may wish to to do a study on that?

      Madhavi you’re one example amongst many where DCR has failed to work and I’m sorry you had to spend so much money on it. What has your surgeon recommended as a treatment? A second DCR?..that’s usually the solution. You may have no other choice other than to have the surgery again. That’s my advice and recommendation as well because “you’ve already been cut open so having it done again makes no difference”. Make sure the bicanicular tubing is left in place long enough to keep the osteum patent and from scarring over.

      Let us all know what you decide to do and keep us up to date. Good luck!!

      Reply
  31. Amanda says:
    July 25, 2015 at 12:31 am

    Hello George,
    I want to say thank you for the wealth of information that you have shared here. After learning about the DCR procedure, there is NO WAY I can handle it. It’s barbaric! My case is a bit unusual. My problem started 10 years ago when I was 18, and I had a severe conjunctivitis infection in both eyes, but the left eye was by far the worst. Ever since the infection cleared, my left eye has been watering. For a decade. I am 28 years old now. About a year and a half ago, I developed a very painful infection and swelling in my lacrimal sac. Antibiotics cleared it up. I have had a full sac ever since, but sometimes it goes down a bit. I had a cold recently, and now it is staying full. I’m terrified of getting another infection, as it was incredibly painful and made my entire left side of my head throb with pain. I’m still traumatized by it to this day. I have severe generalized anxiety disorder and agoraphobia, and I am prone to anxiety attacks, especially when it comes to health issues. I am so scared and depressed, and I don’t know what to do. Is there hope for me, possibly, with these other alternatives?
    . Best Regards, Amanda

    Reply
    • George says:
      July 30, 2015 at 1:04 am

      Dear Amanda, firstly I am very sorry for the delayed response. I’m in Peru at the moment and have very poor internet connection. I have so much to tell you but very limited time with my busy schedule here. Firstly, THERE IS HOPE and you will see a way through this and I’ll help you every step of the way. You need to get on top of two things… 1. You cannot continue with a swollen lacrimal sac. You know this is the reason for ongoing infections. The nasolacrimal ducts have to be cleared to allow the drainage from your lacrimal sac. This certainly can be achieved non-surgically without DCR. The biggest obstacle is locating an open minded eye care professional to do it for you. Most of them want to throw you into DCR surgery.

      2. The other priority for you is to overcome anxiety, panic attacks and depression. I have a website dedicated to overcoming those elements by using deep guided meditations – http://www.mindivine.com.au and there are complimentary strategies to use such as herbs and nutrients that heal, calm, soothe, tone and strengthen the nervous system. Afterall, returning back to nature is ideal since many of us are in the predicament of DCR complications due to “conventional medicine”…only had we have kept it natural and refused their “quick fixes” of surgery. Keep it natural folks!!

      That’s all I have time for now Amanda…again….please forgive a lack of response due to my intensive schedule in Peru.

      Reply
  32. Helen says:
    August 23, 2015 at 3:45 am

    Hi George. Just to keep a little balance…mine is a success story for DCR. I had suffered from watering of my right eye for nearly a year and apart from the inconvenience, it affected my vision and made it difficult to work. I tried hot compresses, massaging, ignoring it, wiping it etc etc. I then saw an opthalmologist who attemped to syringe it but to no avail and he referred me to a surgeon. I was pretty sick of it by now and just wanted it fixed once and for all. The surgeon also attempted syringing but this time he used quite a lot of force (which was momentarily painful) and this time I definitely felt a gush of saline at the back of my nose. He gave me the FML drops and told me to use them until they were finished and said that with a bit of luck, possibly things might be better. He offered me the opportunity to call him if I wanted to arrange for DCR surgery. He explained very concisely how it worked and all the risks but no pressure from him at all to have it done. After one blissful week of being free from watering, it came back with a vengeance.

    I booked myself in and had the surgery 2 weeks ago. There was no post op bleeding from my nose or pain and I didn’t take any time off work apart from the day that I had it done. The tube comes out in 2 weeks from today. My eye is back to normal with no watering or dryness. Maybe I was lucky but I wouldn’t hesitate to have it done again if the other eye started to water. I am 67 years old and very happy with the results.

    Reply
  33. Helen says:
    August 23, 2015 at 3:47 am

    May 29, 2015 at 4:15 pm
    Hi George…just to follow up….I had the tube removed on December 23rd 2014. Now, at June 29th 2015, six months later, I can report that the watering has not returned and the surgery has been a total success. I’ve forgotten how awful a watery eye can be.
    I would like to add that most surgery looks pretty gruesome when viewed on youtube etc and I would recommend that anyone considering an operation of any kind, should stay away from watching the proposed surgery online. I’m not saying that we shouldn’t investigate and educate ourselves because knowledge is power but NEVER watch the surgery on video. No good will come of it and it just creates anxiety. That’s my opinion for what it’s worth. All the best to everyone on here with a watery eye:-)

    Reply
    • George says:
      August 23, 2015 at 6:33 am

      Hi Helen, sorry for taking so long to reply, I had just left to South America with no internet access when you wrote. I am always more than delighted to hear about a success story with DCR and I’m happy for you there were no complications after tube removal. This will give others hope whom have tried the more conservative approaches i talk about (balloon dilatation, stenting, probing), with no success.
      Having said that, I just wanted to make it clear that this is a website for those whom want to avoid surgery. They have the right to explore other, less invasive techniques and I assist and encourage them to do so. Indeed, I was a bit of a cowboy and jumped into DCR after frustration from three occuloplastic surgeons refusing to use the less invasive techniques. As a result, several years later I still suffer from the complications. Not all of us are as lucky as you. I’m very happy for you, but please allow people the choice to chose their own treatments.

      I wish you well and hope you continue on the path to recovery.

      Reply
      • Helen says:
        August 23, 2015 at 2:33 pm

        Hi George

        I completely agree with you that we are all entitled to choice and I would never dream of influencing anyone to have surgery or not, as the case may be. It is up to us all to get together the necessary information in order to make an informed choice. I agree that surgeons often leave out the finer details however they are required by law to spell out the risks.

        I am merely adding my own good experience in (I hope) a balanced and honest manner in much the same way that you have revealed your unfortunate experience.

        You make the point that you didn’t know that bone would be removed. Surely a cursory internet search about DCR would have given you that basic information before you had the surgery?

        Choice is all about informed opinion and I didn’t realise that this site was only for people who wanted to avoid surgery. I apologise for my mistake and wish you well in your search for some relief from your symptoms.

        Kind Regards

        Helen

        Reply
  34. Helen says:
    August 23, 2015 at 3:49 am

    I had a sucessful endoscopic DCR…read my two accounts above (December 10th 2014 and May 29th 2015) as they may help you to decide. I have to say that I find this site depressingly negative about doctors and surgeons. Surely they are not all money-hungry charlatans? I posted my positive experiences to try to add a bit of balance but everyone seems to want to dwell on the bad stuff.

    Good Luck…at least a watery eye isn’t terminal….there’s a lot worse things to have:-)

    Kind Regards

    Helen

    Reply
  35. Anuraag says:
    September 19, 2015 at 8:41 am

    My left eye tears a little. It seems I have partially obstructed tear duct.but when ophthalmologist syringing ,the saline solution pass through the duct.what should I do

    Reply
    • George says:
      September 19, 2015 at 11:59 am

      Hi Anuraag,
      So it seems your tear duct is only partially blocked. Were you given a conservative treatment to begin with? Such as using antibiotics, massaging the tear gland and ‘milking’ out the access tears?

      If the conservative treatments do not help I’d be seeking ‘probing’, ‘balloon dilatation’ and/or ‘stenting’. These lesser invasive techniques have a higher success rate with ‘partially’ blocked ducts.

      Let us know what you find as a successful treatment. Good luck!

      Reply
      • Anuraag says:
        September 21, 2015 at 11:56 am

        Hi George, thanks a lot for reply.They did not given any of conservative method as you describe. At the age of 19 years they probed both of my tear duct three times only in a month. By at that time I did not know such things. My right eye is all well. But the left one tears when there is cold and wind also when I look at another’s eyes . should I go for probing or conservative method . also please define the term “milking”

        Reply
        • George says:
          September 21, 2015 at 8:00 pm

          Hi Anuraag, milking is simply means to ‘massage’ the corner of your eye. Here is a website that mentions the technique along with using a warm compress: http://www.wikihow.com/Clear-a-Blocked-Tear-Duct

          It’s not going to unblock a blocked duct, it will simply squeeze out a bloated tear sac. I used this this technique to speed the leaking of tears down the cheek. The tearing continued, however, it was slower and easier to deal with. It’s something you may wish to try.

          Reply
  36. Ellie says:
    September 19, 2015 at 8:58 am

    Hello,

    I had external DCR about 3/4 months ago and I just wanted to say how pleased I am with it.
    I’ve had no problems other than when the tube was taken out it got very caught and was quite painful and the odd really bad nose bleed when I was recovering.
    But apart from that I’m 100% thrilled with the results. I had mine to correct a functional issue that I have with one of my tear duct in my left eye. They told me all the risks and that in my case it’s only 40-60% effective I opted to have it done and now I’m healed I get 80/90% less tearing, no eye infections like I used to get and overall I’m just thrilled. I’m left with a very small neat flat scar which looks like I’ve had glasses on for too long but I knew that and it’s a lot better than I thought it would be. I’ve had no other problems and I’m thrilled.

    I just wanted to document that DCR surgery can be very good and effective.

    Reply
    • George says:
      September 19, 2015 at 11:48 am

      Thanks for writing to us Ellie. You join a few DCR success stories here (along with ‘Helen’). Indeed, I’m not totally knocking it and the surgery is necessary for a specific group of people. For example, frequent infection of the tear gland (Dacrocystitis) with 100% blocked nasolacrimal duct. DCR is surely indicated for such a condition. Dacrocystitis is dangerous and should not be a recurring condition. So shall we book the DCR in? Well, in my humble opinion that depends on “what the patient” wants. And the surgeon should provide them with ALL the details of the surgery, how it’s performed and ALL the possible consequences. Sadly, that rarely happens and I’ve even had an occuloplastic surgeon inform me that he choses not to mention that bone will be removed during an ‘endoscopic DCR’ because it wards patients away unnecessarily. His tactic is certainly warranted, but not honest. It would have been a deciding factor for me.

      About 20%-30% of DCR surgeries cause air regurgitation from the corner of the eye. Only one surgeon from the few I consulted mentioned it. He trivialized it and said we’d need to hold the side of our eye when we blow our nose.

      It depends on the type of patient and what potential side effects they are happy living with. If the patient is elderly, retired and living with other health problems then perhaps he/she won’t mind at all. On the other hand, if the patient is young with a family to support and only has a very mild, intermittent tearing then DCR maybe too risky. I’d recommend they try antibiotic drops, massaging the tear gland and continue being conservative. In fact ‘Anuraag’ has just written in describing his/her eye only tears ‘a little’, i’m about to respond.

      We do need success stories like yours Ellie to settle those whom DCR is absolutely necessary.

      Reply
  37. Judy Hoxit says:
    October 9, 2015 at 11:19 pm

    Thanks to this blog I sought a second opinion. I had a watering right eye for about three years. The first ophthalmologist said that I need the surgery as soon as possible after he did the saline test and tears ran down my cheek. The second, who was more of a specialist, did the saline test and poked through a membrane that had grown over the duct. I immediately felt the liquid in my throat and was relieved when he told me that no way did I need surgery. I haven’t felt a tear in days.

    Reply
    • George says:
      October 10, 2015 at 12:26 am

      Judy that is fantastic! it seems like the second specialist used a ‘probing’ method? I’ve been advocating on this site that eyes specialists should NOT just rely on the saline syringe test as the main feedback to ammend it with surgery. Some will argue that probing is only temporary relief and eventually you’ll begin to tear again. Let’s hope yours is a permanent relief.
      I went through about 4 specialists whom all refused to ‘probe’ so you were very lucky. All the best to your continued relief.

      Reply
      • Judy Hoxit says:
        October 12, 2015 at 10:17 pm

        The doctor who probed said that if it tears again he would put in a stent. I’m assuming that is easier than the operation??? One week and no tears so far!

        Reply
    • Chris mcminn says:
      November 8, 2015 at 12:03 am

      Hi Judy
      Wish I had read this site. I had surgery under local this week for a blocked tear duct and it was evasive and would not recommend it. I have a high pain tolerance but have been unwell for the past three days. Now my eye is watering non-stop and very uncomfortable. Have a follow up visit this week but terrible bruising and swelling. Have followed all postop instructions. Older patients should never do this.

      Reply
  38. Craig Smith says:
    October 27, 2015 at 5:14 am

    Hello George and others
    I stumbled across this website after on-going tear duct issues. I’d like some comment on this, if any one had any info or personal experiences:
    I had both tear ducts blocked, as the injected saline ran back down my face. I was led to believe the internal DCR was the best treatment. The surgeon placed small plastic tubes in both eyes/ nostrils. I could not tolerate the discomfort and after one week he removed them. Then followed several weeks of tearing – worse then before the surgery. Surgeon found the ducts to still be blocked and I was booked in for a repeat. By the time of the repeat surgery ( 2 months later) my eyes were largely fine., but I went in for the repeat at his recommendation. Now, 4 weeks after the second surgery and the yes are tearing and stinging again. Is this part of the healing process? I’m hoping it gets better again after several weeks, which is kinda what happened the first time . Thanks, Craig in Melbourne, Australia.

    Reply
    • George says:
      October 27, 2015 at 10:45 pm

      Hi Craig, sorry to hear you’re having problems with your eyes. The bicanicular tubing the placed in the corner of your eyes and down into your nostrils was to ensure the osteum remained patent. Since yours was removed so soon the ‘hole’ probably closed over or was still swelling from surgery. I certainly found it irritating but endured it for 6 weeks.

      I couldn’t imagine a second DCR and know people to have them. Why did you have the second DCR if your eyes were fine after two months? Did your surgeon convince you? The healing process is slightly different for everyone. I was not tearing when I had my endoscopic DCR. However, if you wait until the tubing is removed, that will allow more tear drainage out into your nose and the swelling will have reduced. Thus you will hopefully have a satisfactory outcome.

      Good luck with your continued healing.

      Reply
      • Craig Smith says:
        November 2, 2015 at 6:29 am

        Thanks George, for taking the time to respond.
        Yes, the surgeon found that my ducts had closed over after the first surgery and stated quite clearly that it would need to be repeated. And yes, several weeks after the first surgery, my eyes did feel fine. I just trusted that he knew best. Now, 5 and half weeks after the SECOND surgery, my eyes are stinging intermittently and I blink constantly. Going to get him to take a look up my nose- he hasn’t done that yet after the second surgery. I guess he will find that the ducts have closed again, as occurred the first time. IF they heal again, as they did the first time, I certainly won’t let him near my eyes again. But the weeks after the second surgery are passing by with no improvement and I’m starting to get concerned. My big issue is that I could not seem to tolerate the tubing in the corner of my eyes. Maybe I will just need to go a third time and put up with the tubing – cause I currently cannot live with the stinging and blinking. Drives me nuts and it affecting my ability to work,
        Craig

        Reply
        • George says:
          November 3, 2015 at 8:20 am

          Craig if the ducts had closed over after the first surgery, the tearing would occur again. The ducts were created (if we are talking about the same thing? The osteum that was drilled into your nasal bone? and the tubing put through it that had to be kept in place by being twirled through the corners of your eyes). So I’m a bit confused, if your eyes felt fine after the first surgery then why have more surgery?

          After five weeks with the second surgery is the tubing still in your eyes? Perhaps you could have placed drops in your eyes to tolerate the tubing? The tubing needs to remain in the new osteum for at least 5 weeks (some surgeons differ in their opinions about this).

          I understand how eye pain will affect your ability to work and live. It drives you crazy and many people live with this sort of pain daily. Imagine that!

          Good luck and please let us know what happens next.

          Perhaps consult a different surgeon, maybe they can use thinner tubing or use different material. You maybe having an allergic reaction to it.

          Reply
  39. Craig Smith says:
    November 11, 2015 at 1:33 am

    Thanks so much George for your helpful reply.
    Ye,s I had surgery twice, and both times I could not tolerate the fine tubing in corners of my eyes. The first time I lasted one week, the second time, 2 days ! But I guess it was my fault for not trying to put up with it. Had to fly interstate yesterday to give a talk, eyes weeping and stinging throughout !
    It has been now 7 weeks since the second surgery. After the first surgery, I was pretty good at week 10. So, we will see. I wonder too about the allergic reaction to the tube you mentioned.
    Anyway, I have insisted on an appointment to see the surgeon tomorrow, so he can take a look.
    Craig

    Reply
    • George says:
      November 11, 2015 at 11:37 am

      Thanks for the feedback Craig. Flying always causes problems for those with “dry eyes” due to the low humidity. It’s rather strange to have epiphora in both eyes and I wonder what caused it? Perhaps an infection? Dry eyes? The fact that the flight caused a disturbance could indicate a problem with dryness. I wrote elsewhere that ‘reflex tearing’ is a dry eye problem. In fact, ‘dry eyes’ can cause ‘blocked tear ducts’ and induce ongoing tearing!! This occurs because the naso-lacrimal duct that drains the tears into your nose is a very thin mucous membrane and requires ongoing moisture. When the saturation of tears reduce, it dries up, inflames and scars and thus creates a blockage.

      You also seem to be a very good healer. But remember! when the body is cut open it will naturally try and repair itself. The tubing they use to place through the newly developed ‘hole’ in your nasal bone is to stop the healing/closure process. It works! but as we’ve discussed it needs to remain their for several weeks. On the other hand, I’ve known people whom have had the tubing in for several weeks, but had a failed DCR despite the tubing. They’ve gone in for a second DCR usually with success. So this tells us, the osteum can close and scar over despite the tubing. This is NOT good news for you if you decide to have a third DCR. I’d encourage you to try the alternatives mentioned on my site.

      I’m afraid your surgeon may simply tell you he’ll try a third time! Sometimes we need to make our own minds up. Please let us know how the appointment goes and wishing you a positive outcome!

      Reply
      • Craig Smith says:
        November 26, 2015 at 12:04 am

        Hi George and thanks gain for your helpful comments. Unfortunately, after having the DCR twice, I am rather worse than I was before any surgery was attempted.(I went to the surgeon initially because I had intermittent stinging-watering eyes. Had I known what an ordeal I was to have, I would certainly never ever had it done, because in retrospect, it wasn’t so bed. I was just given the impression the op was straightforward and no where did the information sheet state that a possible outcome was WORSE eyes). Anyway, my current symptoms 9 weeks after the second operation are intermittent watering, itching and stinging of both eyes. So whatever the surgeon has done has made them worse ! He recently injected saline into the corners of the eyes and it again ran back out over my face, so the tear ducts are clearly still blocked, its just that they seem worse now.
        However, I find that if I sit in one place all day, I am generally fine. (e.g, yesterday, when I sat in my office all day). Whereas, if I move about, the eyes start to sting and water, presumably because moving allows air to flow across the eyeball (?).
        But the issue for me has always been that I could never tolerate the thin tubes that the surgeon put in place. Both times I insisted he remove them due to irritation (after one week the first time and after one day the second time). But I do admit I never gave the tubes much of a chance. I am told that if I put Flarex eye drops in the eye 4 x daily for first two weeks the irritation subsides. So, yes, I am likely to go for surgery a third time – yikes – but simply man up and tolerate the tubes for the 6 week period. Then just pray it works. I feel that I have no choice because clearly the ducts are blocked and I really should try to hold out for 6 weeks with tubes in place. – Craig

        Reply
  40. Chris says:
    November 30, 2015 at 7:36 pm

    I found this blog this morning because I was scheduled to have a Jones tube put in my left eye on Thursday after a less than successful DCR. I have been having second thoughts about it after reading about the maintenance and the possibility that the tube becomes dislodged. I got thru the DCR without too many issues, but it only improved the tearing by about 30-40%. I went back and he irrigated the duct again and found that the small section closest to the bottom duct is collapsing on itself. He said the solution is to implant the Jones tube. After reading your blog I’m going to live with it a while and if no infections start up, I may not do anything further. Thank you for all of the great information!

    Reply
    • Craig Smith says:
      December 1, 2015 at 2:00 am

      Chris
      I have had two DCR and am scheduled to have a third , hoping it will work this time. The issue has been that I could not tolerate the plastic tubes, but for the third time I will make every attempt to tolerate them ——-IF I have the third surgery. I say IF because my eyes are feeling a little better this week. The most recent (second surgery) was done on September 28 – some nine weeks ago, As someone who has battled through sore eyes twice during recovery period, which both times has dragged on and on – my advice is the wait and see. It seems to take several weeks or up to 3 months for things to settle -at least in my case.
      Craig

      Reply
  41. Jay says:
    January 3, 2016 at 10:50 pm

    Hello George,
    I also stumbled over your blog and am glad that I did. I was told early in 2014 that I have dry eyes. I have been using hot compresses and message for ten years for blufritis. I was put on Resrasis and Systane eye drops in 2014 which did not help for tears. I had the wrong test in both eyes and was told that my right eye is partially blocked. I was told by the Othomologist if I cannot tolerate the years I can see a surgeon. I saw a surgeon who did syringe test and another test to confirm right eye partial blockage. I was given three options. Do nothing if I can live with it or have a tube inserted in the corner of my eye to the nose for three months which has success rate 30 to 40% or have surgery in the nose which seems to DCR and have 85% success rate. When I told the surgeon that I scar hesaid I can go to another surgeon who does it internally. When I asked him what does he recommend, hesaid tubing first will be ok for me. After reading your blog I dot feel comfortable with tubing due to low success rate and possible complications. I am 76 years of age. Is probing or bloon dialation appropriate for me? I can live with tearing if I have to. I still use Resrasis and Sustain eye drops. Your blog has been very informative and helpful. Your opinion would be very helpful also. Thanks.

    Reply
    • George says:
      January 4, 2016 at 1:39 am

      Hi Jay,
      Thanks for writing. I’d need to know which tubing he intends on placing in the corner of your eye. It’s unusual to have it removed after 3 months. But it does seem like the safest option despite the lower success rate. I’d go with the tubing and it may reduce symptoms even further, to a point where any residual tearing is tolerable. Always go for the safest option.

      If you decide on the tubing, we’d all be interested to know how it goes for you.

      Reply
  42. Mildred says:
    January 30, 2016 at 5:39 pm

    Has anyone gotten MRSA either after this surgery where the had to take out my hearin aid and putting it ? Or the possibility of getting this new hearing aid one month before the Jones tube surgery. Been dealing with this Bug since about 3 months after surgery. New aid in 12/13 Surgery 1/14

    Reply
  43. Hemant says:
    February 11, 2016 at 10:22 am

    Hi George,

    I appreciate stupendous work done by you in gathering information on watering of eye , in spite of being a non-medical person ( I presume so ). I am 60 years old and suffering from watery eye ( Left only ) for last one and a half years. I had first infection about a year ago and was contained by antibiotics. Thereafter although watering continued, I was fortunate not to have infection. Meanwhile I noticed that on pressing hard near corner of the eye, tears would flow back from the tear sack into the eye. This gives quite a relief for 4-5 hours until the sack fills up again. The only care I take is to use a clean tissue paper or cotton handkerchief to wipe the tears coming out of eye, to avoid infection. I also clean eyes with water three to four times a day.
    But very recently I had infection again and my doctor has suggested DCR . Today after going thru your blog I have decided to postpone the decision and explore all alternatives.
    I will keep you posted about the developments
    Till then goodbye and good luck to all suffering from this ailment

    Reply
    • George says:
      February 11, 2016 at 10:57 am

      Thank-you for checking in with us hemant. I’m glad you found my site just in time. Please do keep us informed regarding developments and all the best of luck.

      Reply
  44. N.S says:
    February 20, 2016 at 5:48 am

    Hi George,

    Finding your blog was a blessing! As a resident of Toronto (in Canada) and after visiting two of the so called best specialists- my 53 year old mother was told that no matter what she absolutely needs an external DCR. I returned to one of the specialists and asked her for a macro- she refused. I asked for probing/irrigation- she refused. She simply referred us to a balloon-dilation specialist claiming that it would be unsuccessful and no matter what, we would be back to have an external DCR with her. She was rude, and very unprofessional. I asked for all of these things after reading your blog and agree 100% that we should not settle- as it is a matter of health; and rather look for alternatives. I thought of looking into an endoscopic DCR- but again the problem with the bone being cut, we are feeling discouraged again. Why aren’t there more conservative treatment options?! I was told by the rude specialist that my mom has a complete blockage ( not told where, of course- since she didn’t take a macro). She did however put saline solution in and it did not drain in my moms throat. When she pulled the syringe out through a lot of mucous and pus came out. Very regular warm compresses, massage and homeopathic treatments have done nothing for the year or so my mom has had epiphora. My mom has had laser correction surgery about 10 years ago. For about 2-3 months now she is constantly waking up with cold like symptoms- sneezing and needing to blow her nose, and even had discharge in her eye for a while ( although that has stopped), her voice has now developed a nasal quality. She’s always needing to pat her eye to dry tears, and now her nose too. Her tearing though is getting out of hand and interfering with driving and such- and I sincerely wish to help her.

    Does anyone have a name of a surgeon or professional that can possibly help us?! I’d be willing to travel to have this fixed for my mom as well. Anyone who has had a positive experience with getting their blocked tear duct issue resolved and can provide details of their professional would be an asset. Any and all help/advice/opinions is deeply appreciated as well.

    Reply
  45. errol Spaull says:
    June 17, 2016 at 3:54 am

    if only I could have read this article before I would have cancelled my tearduct surgery. today I am suffering from pain and a severe itch that I can’t control. .

    Reply
    • George says:
      June 17, 2016 at 4:00 am

      Hi Errol, thanks for writing to us. Sounds like your surgery was only recent? DCR shouldn’t be very painful post-surgery but itching is possible. It’s always recommended you follow up with your surgeon for advice. Let us know how you are feeling in a few days.

      Reply
  46. Marilyn gilbert says:
    August 23, 2016 at 11:06 am

    Hi. I suffer with watery eyes and find it most annoying. It blurs my sight , I feel as if I am underwater
    I have been prescribed extensive amounts of drops , including FML which worked reasonably well while I was using it.
    Just yesterday after seeing a top Specialst ophthalmic surgeon at the Lions Eye Institute he mentioned this surgery and gave me a pamphlet explaining the procedure
    After reading your story, I will put up with the watery eyes, and i have dry eye as well.
    No way would I consider eye surgery , when I am already an extremely anxious person, and any other complication from surgery would make me a total wreck.
    I had the saline water injected into both tear ducts and he did feel that there was some
    Blockage, which he felt he may have cleared
    He said I would notice an improvement in the tearing during warmer weather
    A trip to the cold section of a supermarket is extremely uncomfortable resulting in heavy tearing for ages after
    Would you mind telling me what the heat treatment you talk about is. Does it involve applying hot packs to the eyes?
    Thinking of you, and what you go through on a daily basis
    Marilyn Gilbert

    Reply
    • George says:
      August 23, 2016 at 12:41 pm

      Dear Marilyn, thanks so much for writing and sharing your experience. I’m so glad and relieved you found my site before being influenced into DCR surgery.

      Anyone who experiences anxiety should think twice about an unnecessary surgery. It’s not heart by-pass surgery that you’ll die if it’s not performed. You’ll live rather well without DCR surgery. But you WILL NOT live well if you have complications from DCR surgery. Your anxiety will compound the problem even further, to the point of making you very ill.

      Watery eyes are MUCH easier and safer to live with than DRY EYES. Watery eyes are simply a nuisance to deal with and can occasionally cause dacryocystitis. Apply some petroleum jelly under your eye where the tears drip down (that’s if they roll down your face), and drain the tear sac daily by squeezing the side of your eye. Dry eyes on the other hand are notoriously difficult to treat and so painful there have been suicides from it. Personally, I’ve spent over $25,000 in treatment over five years for my own dry eyes! Dry eyes can also lead to scarring, thinning, and even perforation of the cornea!

      However Marilyn, you need not despair because your watery eye could be completely cured with the correct surgeon. Always seek a second, third and fourth opinion. A ‘Professor’ or a highly recommended ‘senior’ surgeon isn’t necessarily the best option. In fact, the surgeon whom performed my DCR was deemed one of the best in the state and he charged more than all the other surgeons. He just rushed me into his receptionist’s office to book in for DCR. I had informed him I’m not keen on surgery and could he just try ‘probing’ the blockage with a wire probe. He refused. Now, a surgeon with ‘ethics’ would have complied to my request rather than be in a hurry for his next client and make several thousand dollars from my surgery (there is a clue there).

      Marilyn please go to someone else. My recommendation is to do the following:

      Rather than making appointments and physically consulting eye surgeons, make a list of at least 20 of them. Then phone each one and ask the receptionist if they can ask their surgeon if they will be willing to use ‘balloon dilatation‘ and/or place a ‘stent‘ into the naso-lacrimal duct of an adult for epiphora. You will mostly have positive responses, however, a few will refuse to comply and insist you make an appointment. Just dismiss those and move onto the next surgeon on your list.

      Sadly, after I already had my DCR surgery I tried the technique I recommended for you. About the 12th surgeon I rang, whom was on the other side of Australia PREFERS to use the conservative treatments and indeed would perform what I wanted. But it was too late. So it does work, you just have to be persistent.

      You’ll also come across high profile, but horribly arrogant eye surgeons too. After the drastic complications of my DCR I drove 8 hours to see yet ‘another’ occuloplastic surgeon to see if he could fix the extreme dry eye and air regurgitation from my DCR. He said he could place a ‘stent’ in the DCR hole (I had endonasal DCR), which would almost ‘reverse’ the surgery but claimed I would ‘feel’ the stent. He was probably correct, I wouldn’t want to constantly feel a piece of plastic inside the upper part of my nose. It could also stimulate sneezing. Then after 15 minutes he claimed there was nothing he could do and sent me away. AND I HAD DRIVEN EIGHT HOURS TO SEE HIM. I was not impressed, but became aware how rude and arrogant some surgeons can be. They see us as mechanical machines with no emotions. On the other hand, I have consulted and met the most pleasant, caring, attentive and creative eye surgeons that ‘think outside the box’ and even attempt to invent new surgical techniques to fix my problem. They exist! You just need to find them. I had consulted over 12 eye surgeons (occuloplastic surgeons and ophthalmologists) so have a very good idea whom I’d rather operate on my eyes. I allowed three of these surgeons to attempt three different surgical techniques to reduce my severe dry eyes. I experienced absolutely no side effects, but only moderate results. So it pays to do your study and find a good surgeon!

      Marilyn, during the saline injection into your punctum, did you feel it move to your throat? If you did then you may only have a partial blockage. And your surgeon is correct, a saline flush can actually reduce some of the blockage. Perhaps insist on a few more saline flushes? How about half a dozen of them over two months? Can it do any harm? Not at all, and why would the surgeon refuse?

      I’m also wondering if you have ‘dry eyes’ that can actually cause watering rather than a blockage (it’s referred to as ‘reflex tearing‘). The two can easily be misdiagnosed. I’d insist on a macryodacrocystogram (an X-ray of your nasal system) to locate exactly IF there is a blockage and WHERE it’s located.

      The heat treatment is indeed a heat pack that’s warmed in a microwave and placed over the eyes for a few minutes. It’s particularly useful for those diagnosed with Meibomian Gland Syndrome (MGD) which is the major cause of dry eyes. The heat melts solidified ‘meibum’ within the eyelids that prevents moisture loss from the ocular surface.

      The fact your eyes get cold in the cold section of the supermarket could indicate ‘dryness‘ rather than a watery eye. Dry eyes creeps up on you over the years and eventually become so dry that you experience pain. The lack of tear production can dry the naso-lacrimal duct where the tears drain into your nose. The duct then becomes ‘blocked’ and results in watering. It’s a rather bizarre paradox, but the entire ocular structure is a very complex. We take them for granted.

      Look after your eyes. Don’t read or use computers too long. Get plenty of sleep, use lubricating drops if you’re eyes are dry, squeeze excess tears from the tear sac during periods of tearing, Blink often. Be patient whilst finding the correct eye surgeon to work on you. Remember, it’s YOUR body and YOU chose whom you want to trust with your precious eyes.

      Marilyn, I wish you the very best and hope you find a solution and relief soon. I always encourage people to keep us informed with their progress, it helps others with questions and provides hope. So I look forward to hearing how you are progressing soon!

      Reply
  47. lorie says:
    September 25, 2016 at 4:06 pm

    Diane,
    There is a lot that they don’t tell you about this procedure. I strongly advise to have alternate more conservative treatments done on your loved one. I just got a copy of my medical records in the mail that I requested from UCLA and the doctor states he “explained the risks” of the “surgery such as “loss of vision, closure of the opening and further surgery.” The surgery report says the “bone from the lacrimal fossa was removed.” At no time did he ever say any of the above mentioned to me. Had I known prior I would of never done it. My eye still waters horribly and when I blow my nose air come out through my eye where the surgery was done. My eyelid also droops down a little. Not to mention the bruise (black eye) I still have. So try to get the alternate treatment George was talking about.

    Reply
  48. Snottyeye says:
    March 29, 2017 at 1:14 pm

    Hi George, thanks so much for the time and care you’ve taken on here to share your experience of DCR and warn others. I’m a 56 year old woman in UK, whose runny right eye started only 6 months ago. Lifelong history of allergies, sinus problems, nasal polyps, dry eye, more recently blepharitis, and infections in the eye with blocked duct. Not long before the watery eye I also accidentally bashed my nose while lifting down a metal chair, causing a brief nosebleed. In that eye I developed an infected cyst on lower inner eyelid and conjunctivitis, followed by an ulcer which healed but has remained red. I treated it with ‘Optrex Infected Eye Drops’ from the pharmacy for a few days. Months later the eye still runs constantly, is red on inner lower eyelid and is often gloopy/infected in the tear duct area. The assessing consultant didn’t believe me when I said the tear duct was blocked, until he tried syringing it, twice without success. Then he agreed, said it would need a DCR and referred me to oculoplastic surgeon. I found your site in the meantime so was armed with questions to ask the surgeon. He was so patient and gentle and advised me to seek a second opinion if concerned, and to watch the op on YouTube. However, he said that there was no point trying probing or stents because ‘they simply don’t work’ and that the duct would close up again because of scarring afterwards. I signed the consent form on the understanding that I can withdraw any time in the 3 months waiting time Well I watched the op on YouTube and am full of awe for surgeons but prospect of going through it scares the life out of me! George, it really concerns me that surgeons agree it’s a big, invasive procedure yet no-one will try less invasive approaches first. I saw a GP last week who declined my suggestion of trying antibiotics (haven’t used any for 12 years) for my horrendous sinus pain and constantly gloopy eye, yet post-op these will be routinely prescribed. It seems that the only alternatives are ‘live with it’ or ‘DCR’. I’ve been trying massage and have discovered that when the tear duct area is congested, I can press a an area that sends tears down my nose. The consultants gave me a bemused smile when I said this, but now I can do this several times a day and it makes me wonder if I could eventually clear it. Any suggestions at all would be gladly accepted; I’m in such a dilemma and very thankful for your research and experience.

    Reply
  49. Marea says:
    April 20, 2017 at 12:28 am

    Hi everyone

    I am so glad I have read this Blog … I have had a blocked Tear Duct for a few years now .. I did consult a specialist back then ..( no bedside manner at all ) and you feel like they do not want to answer your questions.
    He did try to clear the duct with the saline but that did not work… so he suggested the surgery .. which I said I would think about as I knew it entailed the drilling into the bone. So I have been putting up with my watery eye.

    Yesterday I decided to visit my local GP as my eye had been getting some yellow discharge coming out so I was bathing it with a saline bath each morning and night which did improve it and it cleared up somewhat but thought I better get it checked… Well my local GP then started on me about having the surgery done for the blocked tear duct… and said dont I want quality of life with out the tears.. he even went and wrote out the referral to the Specialist I seen before… he was very pushy for me to get it done.. So The Refferal is sitting here in the drawer.. I think it will stay there now after reading your experience George.. At 71 with anxiety I could not face that operation .. and as you say they cannot give you a 100% success rate.

    Thank you
    Marea

    I

    Reply
    • George says:
      April 20, 2017 at 2:19 am

      Hi Marea…
      As we age the tear duct can narrow and become blocked. So the DCR surgery is common amongst your age group.

      What I suggest is you compile a list of eye surgeons and ring them one at a time. Ask their secretary if their surgeon performs ‘ductal probing’, ‘balloon dilatation’ and stent placement as alternatives to DCR on an adult. You should push for a simple Yes or No answer.

      You may find a positive result in 1 out of 6 phone calls. I find this is the best strategy, rather than making an appointment and wasting your money and time just to be told they won’t entertain anything other than DCR surgery.

      Give it a go! Perhaps it could be a task for you that will pay off dividends. It can pay to put some effort into our own research and tracking our own specialists down.

      Let us know how you go!

      Reply
  50. Marea says:
    April 20, 2017 at 2:54 am

    Thank you for your reply George much appreciated I will see how my eye is if it dosnt get any worse with thecwatering I think I can put up with it..without doing through anything..as I live in a small town here in Australia we do not have tje option to many Specialists…. So I will see how things go.
    Thanks
    Marea.

    Reply
    • George says:
      April 20, 2017 at 6:12 am

      It’s a small world Marea. I also live in a rural town of Australia in Victoria. I’ve seen several eye surgeons in three states of Australia.

      I’m aware of a few surgeons who would be willing to work with you here on a more conservative approach. They would go the extra mile and provide for your individual needs.

      So if you decide you can’t live with the tearing anymore, please do contact me again for a referral.

      Reply
  51. Marea says:
    April 20, 2017 at 6:53 am

    George thank you I certainly will keep that in mind. The Specialist I did see was in Lismore …I live in Casino on the Northern Rivers N.S.W..I will keep up my Saline eye baths twice a day…and keep fingers crossed the tearing does not get worse.
    Cheers.

    Reply
  52. William says:
    November 28, 2017 at 10:16 pm

    Thank You for sharing your story! I almost had the surgery ! Very glad I didn’t !
    Tears still flow down my cheeks like rain, but I will grin and bear it !
    I’ll pray for you to be healed.

    Reply
    • George says:
      November 29, 2017 at 4:04 am

      Hi William. I’d highly advise you not to go untreated. If you are tearing profusely you need treatment because the risk for infection is very high and it’s just plain ANNOYING to live with. Eventually, you will get so sick of it, that you’ll want relief. My website is full of advice on effective, alternative treatments to DCR and I recommend you sort them out. Good luck, and please let us all know if you do go ahead with treatment.

      Reply
  53. vicky says:
    December 6, 2017 at 5:35 pm

    I had a DCR done after the probing didn’t work, my issue is I still have watering of the eye, Dr. wants to do another probing, at the cost of $500 do you think it would do any good or should I just deal with it?

    Reply
  54. Udesh Kumar says:
    January 24, 2018 at 6:36 pm

    Thanks for your valuable & exhaustive information. Could you pls. elaborate all the alternative options for someone (like me) who has dry eyes and has glaucoma for last 20 years but has a severe tear duct blockage for last six months and Punctoplasty has not helped matters? I shall deeply appreciate your inputs as I have been advised an external DCR Surgery(after a DCR x-Ray of course) but am yet debating on it. Hence the request for alternative options. Thanks . Udesh kumar from Melbourne. Mbl.0401331329

    Reply
    • George says:
      February 7, 2018 at 10:25 am

      Hi Udesh, Sorry for the late reply. I was on a health retreat from 16-29 January without much mobile reception. If you’re still around what did you decide to do? I’d be happy to speak with you on the phone.

      Reply
  55. Linda says:
    March 18, 2018 at 5:36 am

    Thanks for the information. I was diagnosed with a tear duct obstruction on my left eye about five years ago. Had a consultation with an specialist who recommended the DCR procedure. He told me that he would have to make a hole in my bone to create another way for the tears to drain through my nose. I told him I was going to think about it but never went back to see him. I thought the procedure was too invasive and decided against it. The tearing got worse with time and I started to get a sticky clear discharge from time to time. Then two years ago, I got an eye infection which was treated with an antibiotic eye cream. After that, the sticky discharged became more frequent and my eye would get red and swollen more often. Since I was told that the DCR was the only way to solve the problem, i decided to look for a good surgeon so I could have it done this year. The middle of January, I woke up one morning with a swollen red eye and pus on the corner of my eye. I put on the antibiotic cream and called my doctor. He didn’t have any appointments available for a week. The next day, there was no pus but my eye hurt really bad. I went to an emergency care facility and was diagnosed with conjuntivitis and a sty. The doctor prescribed oral antibiotics and eye drops. Took the medication but it didn’t help. The pain on my eye and my face got worse so I went to the ER. A CT scan revealed a periorbital abscess. I was transferred to John Hopkins Hospital. Fortunately, the aggresive antibiotic treatment worked and they didn’t have to get in to drain the abscess. The doctors told me that the infection was due to the tear duct obstruction and that I needed the DCR surgery as soon as I got better or I would probably get another another infection. I was hospitalized for three days. I had the surgery about a month later. mine was an external DCR. The incision close to my eye has healed well but I developed pressure headaches and a runny nose. A CT scan taken without contrast was normal so the doctor ruled out spinal fluid leakage which is great but I still have the headaches every day. The stent in my nose was removed but the one in my eye needs to stay there for three months. I don’t have the tearing in my eye anymore so I guess the surgery can be considered successful. I hope the headaches will eventually go away. I searched online to find more information about them and I found your blog. Has anyone had this problem as a result of the surgery? If so, did the headaches stop after awhile? I would really appreciate any feedback. Thanks.

    Reply
    • George says:
      March 26, 2018 at 4:03 am

      Dear Linda, thank-you for writing and apologies for the delay in responding. The amount of emails I receive for DCR issues is phenomenal. There are a lot of complications with DCR surgery, especially at the beginning. Many will go away with time, others remain as permanent.

      It’s a very invasive surgery for a rather minor issue! Sadly, a majority of eye surgeons simply tell us that DCR is the only way. But it’s not! It’s misleading information. But they refuse to do anything else. But in your situation with chronic eye infections, you made the only logical choice you could.

      It’s been a few days since you posted this. How are your headaches now? They should diminish, but we never dismiss it as pain resulting from something more serious.

      We all wish you a speedy recovery and continued improvement. Please keep us up to date with your progress.

      Reply
  56. Kris says:
    October 25, 2018 at 3:11 pm

    I had external DCR on May 4th 2018, I am going back to get them removed Nov. 9 2018, yes a long 6 months, I have had headaches, eye pressure, but my eyes do not leak anymore so that is good. My question is for all of you that have had the surgery, how do they remove them and does it hurt?

    Thank you,
    Kris

    Reply
  57. Natalia says:
    October 30, 2018 at 2:07 pm

    George, after reading about all these horrible cases on your blog, I brought my concerns to my Ophthalmologist. I am due for the Endoscopic DCR in a week. The doctor said that though the new hole cut is 5 mm, but the tissues will close it to the size of the tube that is inserted into the new hole for several weeks. Thus the real hole left will be only 1mm.
    Secondly,he said that if you are so unhappy or unlucky with the results, you can always close this new hole and bring yourself to the previous condition.
    My question: then why all of you, who speak about so many irreversible complications, have never gone back to your doctors and closed the hole? You complain that the consequences of DCR are worse than just damping the tears before it and that the situation is irreversible…
    But it sounds like it is reversible! Why won’t you go and close the hole? May be you should…or there were other complications with it?
    I would appreciate your response, if possible, before my EDCR at the end of this week.
    Thank you,
    Natalia

    Reply
    • George says:
      October 31, 2018 at 12:26 pm

      Hi Natalie,

      I’ve seen many oculoplastic surgeons to reverse my DCR between 2007-2012. Some of our countries top surgeons were not able to suggest a safe and reliable way to permanently close the hole. What do you replace bone with? One surgeon suggested he could put a stent in the DCR hole, but I’d constantly feel the sensation of it – that’d be awful.

      Ask your surgeon exactly how he proposes to close the hole? I doubt he can do it!!

      I wish you the very best with your Endoscopic DCR and hope it well…

      Reply

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