Dacryocystorhinostomy (DCR) is a surgical procedure that can treat blocked nasolacrimal ducts, the pathways through which tears drain from the eyes into the nose. A blockage of these ducts leads to tear accumulation, resulting in excessive tearing, recurrent eye infections, and pain or swelling at the medial corner of the eye. The surgical procedure involves creating an alternative pathway to drain tears from the lacrimal sac into the nasal cavity. DCR may be performed externally or via an internal endoscopic procedure. Endoscopic DCR, the more popular approach, requires no external facial scars and provides excellent visualization, facilitating a swift recovery. In cases of tear drainage disorders, it is usually performed by the ENT team in conjunction with the ophthalmology team.
Blockages of the tear ducts may be attributed to chronic infections or inflammation, previous trauma, aging, changes in nasal anatomy (e.g., deviations, nasal polyps), sinusitis, or previous operations on the nasal structures or face. Over long periods, these blockages can predispose patients to recurrent infections (dacryocystitis), which often become acutely painful and accompanied by swelling of the lacrimal sac. DCR has a high success rate and significantly reduces discomfort associated with excessive tearing or recurrent eye infections.
The nasolacrimal duct is a small passage through which tears from the eyes drain into the nasal cavity.
The functions of the tear drainage system are to:
When the tear duct is blocked, this drainage pathway is interrupted.
Patients who have a chronic or complete obstruction of their tear drainage system require surgical intervention.
Indications for DCR surgery may include:
Persistent complaints usually necessitate surgery to relieve discomfort and infection and to restore normal tear drainage.
Several problems can affect the tear ducts, resulting in an obstruction:
A long-term obstruction can lead to acute infection and significant inflammation of the tear duct, resulting in painful swelling.
The signs of an obstruction of the nasolacrimal duct usually affect the eye and the inner corner of the face.
Common Symptoms are:
It is particularly common for the symptoms to be exacerbated by cold weather, colds, or allergies.
A precise diagnosis is required to plan for the DCR procedure and to guide any necessary ancillary tests or surgical approach.
Diagnostic investigations may include:
These investigations confirm the diagnosis and help locate and characterize the site and nature of any blockage.
DCR surgery can be performed via external or endoscopic approaches, depending on the specific clinical circumstances.
The endoscopic approach requires no external facial incision or scar and typically takes 30-40 minutes. The latest high-definition nasal endoscopy equipment permits high precision and an excellent visual field.
Recovery from DCR surgery that is performed externally takes about 2 weeks, while the recovery period for an endoscopic procedure may take 5 to 7 days. Post-surgery care includes nasal sprays, antibiotic therapy for infection, pain-relief medication, and saline wash. It is normal to have some nasal obstruction.
DCR surgery helps a person achieve long-lasting relief by ensuring proper drainage of tears, reducing the risk of eye infections, preventing swelling, and stopping excessive tear production. This will result in clearer vision, eye comfort, and improved quality of life.
Most patients will benefit from the procedure and have complete resolution of their symptoms.
DCR surgery is usually a safe procedure, but potential complications may occur:
Skilled surgeons, along with careful postoperative care and follow-up, minimize the risk of any complication.
Long-term care should help maintain normal tear drainage:
Most individuals will be able to resume all normal daily activities within one week after endoscopic surgery and between two and three weeks after the external procedure.
LIKITA Hospital is a trusted ENT Centre for Dacryocystorhinostomy (DCR) Surgery in Patna, Bihar, India, providing specialized evaluation and treatment for nasolacrimal duct obstruction, blocked tear ducts, excessive tearing, and recurrent dacryocystitis. Our experienced ENT surgeons use advanced nasal endoscopy and minimally invasive endoscopic DCR techniques, with appropriate coordination with ophthalmology specialists when required. With detailed diagnosis, precise surgical treatment, and dedicated postoperative follow-up, LIKITA Hospital focuses on restoring normal tear drainage, reducing recurrent infections, supporting faster recovery, and improving long-term eye and nasal comfort.
