Epiphora (watery eye) may have a multitude of contributory factors. Watering may be due to over secretion of tears, usually in response to eye irritation or dryness of the surface of the eye, or due to impaired tear drainage, caused by a blocked tear duct or malposition or narrowing of the top opening of the tear drainage system (punctum). Distinguishing the underlying causes requires a thorough assessment, often including a minor syringing procedure of the tear duct to assess whether it is blocked.
The treatment for a blocked tear duct is a dacryocystorhinostomy (DCR). This is usually performed under general anaesthetic, but can be performed under local anaesthetic. Young, fit patients may have their surgery performed as a day case, but most elderly patients require an overnight stay in hospital.
An incision is made on the side of the bridge of the nose and the blockage of the tear duct is bypassed by creating a direct communication between the lacrimal (tear) sac and the inside of the nose. Fine silicone tubes are usually placed in the tear ductules for several weeks after the surgery.
Patients are advised to take 1 to 2 weeks off work after the surgery.
In cases where the opening of the tear duct within the eyelid (punctum) is narrowed, a minor procedure to widen the punctum surgically can be performed under local anaesthetic.