Medically reviewed by Dr. Niranjana Bejan Singh. Written to established clinical-education standards (AAO/Mayo/NHS/NEI) and adapted for this hospital. Not a substitute for professional medical advice.
Dacryocystorhinostomy, usually shortened to DCR, is a surgical procedure that creates a new drainage pathway for tears when the nasolacrimal duct (the channel that normally carries tears from the eye into the nose) is blocked. The blockage causes tears to back up, leading to a persistently watery eye (epiphora) and repeated infections of the tear sac (dacryocystitis). DCR connects the tear sac directly to the inside of the nose, bypassing the blocked segment so tears can drain normally again. It can be performed through an external skin incision or entirely through the nostril using an endoscope.
Who typically needs this
- People with a confirmed blocked or narrowed nasolacrimal duct causing constant watering of one or both eyes.
- Patients who have had one or more episodes of acute dacryocystitis (a painful, swollen infection of the tear sac near the inner corner of the eye).
- Those with chronic discharge, crusting, or a visible swelling near the inner corner of the eye due to tear sac blockage.
- Patients for whom simpler treatments — such as tear duct probing, dilation, or temporary stenting — have not resolved the blockage.
What to expect
- The surgeon confirms the site and extent of the blockage beforehand, sometimes with dye tests, syringing, or imaging of the tear drainage system.
- DCR is done under general or local anaesthesia with sedation, and typically takes under an hour.
- In the external approach, a small incision is made on the side of the nose near the inner corner of the eye to reach the tear sac and bone.
- In the endoscopic (endonasal) approach, the same connection is made working through the nostril, leaving no visible skin incision.
- A small window is created in the bone between the tear sac and the nasal cavity; a temporary soft silicone tube is often left in place across the new opening to keep it from closing while it heals.
Recovery
- Mild swelling, bruising, and some blood-tinged discharge from the nose are common for the first several days.
- Any external skin stitches are usually removed within one to two weeks; endoscopic DCR leaves no external scar.
- A temporary silicone stent, if placed, is generally left in for several weeks to a few months and then removed in the clinic.
- Most people resume normal daily activities within a week or two, avoiding nose-blowing and strenuous exercise until cleared by the surgeon.
Risks to know about
- As with any surgery, bleeding, infection, and reactions to anaesthesia are possible.
- The new drainage opening can occasionally scar down or narrow over time, causing the watering to return and sometimes requiring repeat surgery.
- Some patients notice temporary or, rarely, persistent numbness or a change in sensation near the surgical site, and external DCR leaves a small scar.
- The stent, if used, can shift or cause irritation before it is removed.
Frequently asked questions
Will I have a visible scar after DCR?
Endoscopic DCR is done through the nostril and leaves no visible scar. External DCR leaves a small scar beside the nose that usually fades considerably over several months.
How soon will my eye stop watering?
Many patients notice improvement within days to weeks, though full settling can take a few months while the new drainage channel heals.
Is DCR always successful?
DCR has a high success rate for relieving blockage-related watering and infection, but as with any surgery, the passage can occasionally narrow again and need further treatment.
Will I need the stent removed in a separate visit?
Yes, if a stent is placed, it is removed in a quick, generally painless clinic procedure once the surgeon confirms the new passage has healed.
Ready to see us?
Call the appointment desk, or book online — we will confirm your time by phone.
Sources consulted: NHS — Blocked tear duct, AAO — What Is Dacryocystitis? . General medical information — not a substitute for professional diagnosis. Medically reviewed by Dr. Niranjana Bejan Singh.
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