Blocked tear duct surgery

Blocked tear duct surgery in Iran

Tear Duct Surgery

What Is a Dacryocystorhinostomy?

A dacryocystorhinostomy (DCR) is a procedure that makes a new path between your eyes and your nose for draining the tears. You may need this surgery if your tear duct has become blocked. The procedure can be performed externally through an incision in the skin, or endoscopically through the nose without leaving a skin incision. Both methods are equally successful.

Blocked Tear Duct

Your eyelids each have a small opening that drains away tears produced normally by your eyes. Blinking pushes tears into these openings. From there, the tears empty into a small tube and then into a larger area: the lacrimal sac. This sac leads to the tear duct, which goes around bony structures surrounding your nose and drains into your nasal cavity.

Symptoms of a Blocked Tear Duct

Symptoms include:

. Tearing

. Discharge from the eye

. Pain at the tear duct or surrounding area

Causes of a Blocked Tear Duct

In most cases, the cause of a blocked tear duct is not known. Other times, the blockage can be caused by health problems such as:

. Anatomical problems you were born with

. Chronic nasal and sinus inflammation

. Obstruction from a tumor

. Trauma to the nose

. Conjunctivitis

An ophthalmologist will perform testing of the tear duct to determine if there is obstruction and what the cause may be.

Why Might I Need a Dacryocystorhinostomy (DCR)?

The procedure is done to relieve the symptoms of a blocked tear duct. These include excessive eye watering or crusting around your eye. If the duct is infected, you might have the following symptoms:

. Swelling and tenderness around your eye

. Eye irritation

. Mucous discharge

Not everyone who has a blocked tear duct needs a DCR. This is a much more common treatment for adults than for children. Your health care provider might first recommend less invasive treatments. These may include warm compresses, massage, and antibiotics for an infection. Or the provider might advise having a procedure to try to dilate the nasolacrimal duct. If your symptoms are severe, however, you may need a DCR.

Depending on the cause of your blocked tear duct, you may need another treatment. For example, you might need a different kind of surgery if a tumor blocks your duct.

You and your health care provider may need to discuss what type of DCR will be best for you. Sometimes, providers perform the procedure externally. Other times, they use a rigid tube inserted into the nasal cavity to perform the surgery. With this approach, you might be able to avoid an external scar. Ask your eye doctor about the benefits and risks of all your treatment options.

What Are the Risks of a Dacryocystorhinostomy (DCR)?

All procedures have risks. Risks of this procedure include:

. Abnormally fused tissue in the nose

. Displacement of the stent placed in the duct

. Excess bleeding

. Infection

. Prominent facial scar (external DCR only)

It’s also possible that the DCR will not be effective.

Your risks may differ according to your age, your health conditions, and the type of DCR performed and the reasons for it. Talk with your doctor about all your concerns and about the risks that apply the most to you.

How Do I Prepare for A Dacryocystorhinostomy (DCR)?

Talk with your doctor about how to prepare for the procedure. Ask if you need to stop taking any medicines. You can’t eat anything after midnight before the day of the surgery.

Your doctor may want tests before the procedure to get a better idea of your anatomy. These might include:

. CT scan of your nasal passages

. MRI scan of your nasal passages

Tear Duct Surgery Procedure

. DCR Through the Skin (External Procedure)

During an external DCR, your oculoplastic surgeon creates an opening from the lacrimal sac to your nasal cavity. The surgeon makes a small incision in the skin, in the area under your eye and next to your nose. Through this incision, your surgeon creates a small opening in the bone beneath. This opening then connects your lacrimal sac and your nasal cavity. The surgeon leaves a small tube there to help keep the new tear duct open.

. Endoscopic DCR (Minimally Invasive)

During an endoscopic DCR, the sinus surgeon works together with the eye surgeon to bypass the tear duct by creating a new opening directly from the lacrimal sac to your nasal cavity. Going through the nasal passage under endoscopic vision, the sinus surgeon creates an opening in the bone that overlies the lacrimal sac. A connection is then created between the lacrimal sac and your nasal cavity. The ophthalmic plastic surgeon usually places a small tube there to help keep the new tear duct open.

What Happens During a Dacryocystorhinostomy (DCR)?

Talk with your doctor about what will happen during the procedure. The details of your surgery will differ if it is an external or an endoscopic approach. Usually, a doctor trained in ophthalmic plastic surgery performs the external surgery or partners with a sinus surgeon to perform an endoscopic DCR — in either case, with the help of a team of specialized nurses. In general, you can expect the following during your surgery:

. You may be awake during an external DCR surgery. You may receive a medicine to help you relax. The doctor uses packing materials soaked with anesthetics inside your nose to make sure you don’t feel anything. This packing material may also have medicine to help you bleed less during the procedure. You may also need an injection to numb the area.

. For other external DCRs, and during all endoscopic DCRs, you will receive anesthesia to make you sleep. You will sleep deeply through the surgery and won’t remember it afterward.

. Your ophthalmic plastic surgeon may make a small incision below or near your eyelid, in the space below your eye and beside your nose.

. The ophthalmic plastic surgery doctor may expose the tissue beneath the incision. He or she will make a small hole in the bone beneath to open a new passageway between the lacrimal sac and your nose.

. Your sinus surgeon may use an endoscope to work through the nose to make an opening in the bone that overlies the lacrimal sac, to make a new passageway between the lacrimal sac and your nose.

. In most DCR cases, a small tube called a stent will be placed in the opening to help keep the passage open.

. For an external DCR, your incision will be closed with stitches.

. For an endoscopic DCR, no sutures or nasal packing will be placed.

Blocked Tear Duct Surgery Recovery

Ask your doctor about what you should expect after your external DCR surgery. Your nose may need to be refilled with packing material to reduce the chance of bleeding. In most external and endoscopic DCR cases, you will be able to go home the same day. Plan to have someone go home with you after the procedure.

Be sure to follow your doctor’s instructions about caring for your eye, nose and wound. You may need to take antibiotics or antibiotic eyedrops to help prevent infection. Your doctor might also give you instructions about rinsing the nasal cavity. You may need other medicines too, such as steroids and nasal decongestants.

There may be a little soreness after the procedure, but over-the-counter pain medicines should relieve the discomfort. It is normal to have some bruising after an external DCR. There is typically no bruising after an endoscopic DCR.  Ask your doctor if there are activities you should avoid while you recover.

You will need close follow-up care with your doctor to find out if the surgery was effective. You may have a scheduled appointment soon after the procedure. You will need continued follow-up care to monitor how you are doing after your surgery. If a stent was placed, it might need to be removed a few weeks after the procedure. Tell your doctor right away if you have excessive bleeding, a fever, or increasing pain or swelling.

About Iranian Surgery

Iranian surgery is an online medical tourism platform where you can find the best ophthalmologists in Iran. The price of Tear Duct Surgery in Iran can vary according to each individual’s case and will be determined by an in-person assessment with the doctor.

For more information about the cost of Tear Duct Surgery in Iran and to schedule an appointment in advance, you can contact Iranian Surgery consultants via WhatsApp number 0098 901 929 0946. This service is completely free.

Source:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/dacryocystorhinostomy  

10 common question about tear duct surgery

1How is tear duct surgery performed?
A DCR is performed through a skin incision, which is made on the side of the nose. ... In some people, during surgery, a clear plastic tube is placed from the inside corner of the eye into the nose. The tube is used to stent the tear drainage system and prevent scarring.
2Is tear duct surgery painful?
It may be uncomfortable for the first few days, but will get better as time passes. Do not move it around. Sometimes, the tube can come part or all of the way out of the tear duct. Don't worry.
3How do you unclog a tear duct?
Carefully clean the eyelids using a warm, wet washcloth if tears build up and leave crusts. For infants, you may try gently massaging the area 2 to 3 times a day. Using a clean finger, rub the area from the inside corner of the eye toward the nose. This may help to open the tear duct.
4Is a blocked tear duct painful?
The most common symptom of a blocked tear duct is watery eyes and tears streaming from the eyes. Other symptoms of a blocked tear duct can include: redness and irritation of the affected eye. ... pain and swelling of the inside corner of the eye.
5What is the surgery for blocked tear duct?
The surgery that's commonly used to treat blocked tear ducts is called dacryocystorhinostomy (DAK-ree-oh-sis-toe-rye-nohs-tuh-me). This procedure opens the passageway for tears to drain out your nose again. First you're given a general anesthetic, or a local anesthetic if it's performed as an outpatient procedure.
6How long does blocked tear duct surgery take?
The procedure takes about an hour. The tubes stay in place for three to six months to open up the ducts and let tears drain. Intubation can cause side effects such as: A stuffy nose (saline drops can help relieve the congestion)
7Do tear ducts drain into sinuses?
The duct begins in the eye socket between the maxillary and lacrimal bones, from where it passes downwards and backwards. ... Excess tears flow through nasolacrimal duct which drains into the inferior nasal meatus.
8Are Blocked tear ducts contagious?
Pink eye is highly contagious and easily spreads from one person to another. In contrast, blocked tear ducts happen to infants due to something getting stuck inside the tear duct preventing the normal flow of tears and the fluid around the eyelid.
9How do I know if my tear ducts are blocked?
Signs and symptoms of a blocked tear duct include: Excessive tearing. Redness of the white part of the eye. ... Mucus or pus discharge from the lids and surface of the eye.
10How can I unclog my eye glands?
Poor secretions should be treated by lid hygiene and massaged with a moist cotton tip in order to remove debris from the eye and increase blood flow so as to open up occluded meibomian glands. Warm compresses will also unblock the glands, as a higher compress temperature will liquefy viscous meibum.

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