Dr. Iyengar performed surgery on my eye to fix a blocked tear duct. The surgery, called a dacryocystorhinostomy, or DCR, involved creating a hole between the tear sac and the inside of the nose. The surgery went very well, with little swelling and negligible post-operative pain. The problem with the tear duct is fixed. To my delight and amazement, the scar from the incision along the side of my nose is nearly impossible to see! Just a beautiful job! Best of all, Dr. Iyengar is a very caring, gentle professional who gave me complete confidence in his skill and ability to achieve the best possible outcome for me.

Candace S. on

Procedures - Tear Duct / Lacrimal Surgery

Tearing can be caused by dry eye, allergies, and reduced drainage within the tear drainage system. The tearing system shown below shows the general anatomy of tear flow. Tears are produced by glands within the eyelid and in the upper part of the eyelid towards the ear. The tears then cover the eye providing lubrication. As we blink, the tears are moved toward the nose and into two small holes that lead into the tear drainage system. Sometimes the tear holes themselves are very small and tears cannot drain efficiently. This then causes them to run down the cheek. Obstruction of the tear duct can also occur further downstream before the tears normally empty in the nose.




We treat a number of different tearing problems, both simple and complex. We may treat dry eyes by placing punctal plugs or punctal occlusion. Occasionally tightening and raising the lower eyelid will improve dry eyes as well. We also treat children with congenital nasolacrimal duct obstructions. This can be repaired by probing or placing a temporary silicone tube in the duct. Tearing problems in adults may be related to a narrow punctum or obstruction of the nasolacrimal duct within the nose.

Partial or complete nasolacrimal duct obstructions usually require an outpatient procedure such as a dacryocystorhinostomy or DCR. This procedure can be performed endoscopically or via a small incision on the side of the nose. A small tube is inserted at the time of surgery and then removed in the office at a later date.

Tear duct surgery is performed as an outpatient procedure and has a very high success rate.