Tear duct blockage (or Nasolacrimal Duct obstruction - NLDO) is a common eye condition, which can affect people of all ages. The tear passages run from the inner eyelids to the back of nose, and can become blocked at any point along this pathway.

Symptoms

  • NLDO causes a watery eye.
  • Initially the watering is present in cold or windy conditions, and with time it becomes constant.
  • Watering of the eye causes tears to well up in the eye or drip onto spectacles, causing blurring of vision.
  • Watering of the eye requires constant mopping of tears from the cheek, which can irritate the skin.
  • Blockage of the tear duct can lead to infection, which causes stickiness and infection.

Causes

The most common cause of NLDO is an age-related narrowing of the tear duct at the side of the upper part of the nose.

The condition can also be present from birth, or produced by lesions within the tear passages.

Treatment

In most cases, surgery to bypass the obstruction in the tear duct is required (Dacryocystorrhinostomy – DCR). This operation is usually performed under general anaesthetic and takes about 60 minutes. The procedure can be performed through a small cut at the upper part of the nose, or via the nose itself, which produces scarless surgery. The vast majority of cases can be performed endoscopically via the nose, and Mr Ismail will advise which approach is suitable for you. At the time of surgery, a thin piece of flexible tubing is placed into the bypass to help it remain open. This is usually removed in the clinic a few weeks later.

Although DCR surgery is very successful, a minority of operations may not improve watering. If this is the case, Mr Ismail will discuss whether further surgery is advisable.

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