What is a Lacrimal Disease?
The nasolacrimal duct is the tear duct system that drains the normal tears away from the eye and into the sinuses. There is a need for constant balance– too many tears produce the annoying symptoms of blurred vision and a wet face; too few tears create the misery of dry eyes.
What causes tearing?
There are two general causes of tearing– abnormalities of the nasolacrimal duct and reflex tearing whereby any irritation to the eyes causes reflexive tear production (i.e. wind, dust, pollution). The most common cause of annoying reflex tearing is the dry eye syndrome and meibomian gland disease. In these cases, surgery to improve the tear drainage system will worsen an existing dry eye.
Our oculoplastic surgeons have special expertise in tear duct surgery, but before the tear outflow system can be surgically corrected it is critical to ensure that the cause is poor drainage or outflow obstruction. If the problem is reflexive tearing, there is no surgical cure and the key is symptom management typically with a combination of eye drops, eye ointments, and warm compresses.
How is tearing evaluated?
Evaluation of the tear duct is based upon history, and also the anatomy of the tear duct. This is assessed by the simple nasolacrimal duct irrigation performed in the office using just eye drops for freezing. This is not a treatment – it is diagnostic, and allows the doctor to identify the presence and location of a blockage.
What is tear duct surgery?
Congenital tearing is common in infants, and persistence of tearing past one year of age is often treated with a ‘probing and irrigation’. If this is unsuccessful, occasionally a temporary stent will need to be placed along with the probing.
In an adult, if there is a blockage in the tear duct, a dacryocystorhinostomy (DCR) is most commonly performed. Frequently, temporary stents are placed as part of the DCR and are removed in the office several months later. This operation can be done either through a small skin incision or through the nose i.e. endonasal DCR. Pros and cons of these different approaches are discussed with the surgeon.
Sometimes it is not possible to use the natural tissues to rebuild the tear duct and then a permanent artificial tear duct is created using the pyrex glass Lester Jones tube – this is the conjunctivodacryocystorhinostomy (CDCR).
Explore More Conditions
We specialize in diagnosing and treating a variety of complex eye conditions that can affect both vision and appearance. From Orbital Disease and Thyroid Eye Disease to Lacrimal Disease and the management of Anophthalmic Socket, our expert care is tailored to restore function and improve quality of life. Explore the various conditions below to learn more about the causes, symptoms, and treatments available for these conditions, and how our team can support you on your journey to better eye health.
Lacrimal Disease (Tearing)
The nasolacrimal duct is the tear duct system that drains the normal tears away from the eye and into the sinuses. There is a need for constant balance– too many tears produce the annoying symptoms of blurred vision and a wet face; too few tears create the misery of dry eyes.
Anophthalmic Socket
Tragically, eyes are still lost to trauma, tumours, and severe ocular diseases. The role of enucleation (removal of an eye) and the reconstructive work of socket repair using implants are integral parts of our practice. We work in tandem with excellent ocularists in town who create custom prostheses.
