Dacryocystorhinostomy (DCR) · Punctoplasty · Lacrimal intubation | Chronic tearing
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Tear duct surgery treats obstruction of the system that drains tears from the eye into the nose. When this duct becomes blocked, tears can’t drain properly and overflow onto the cheek (epiphora); this can be accompanied by crusting, intermittent blurry vision, and repeated infections of the tear sac (dacryocystitis).
In adults, the most common cause is age-related narrowing of the nasolacrimal duct, more frequent in women after menopause; it can also result from trauma, chronic infections of the nose or sinuses, narrowing of the tear puncta, or, in rare cases, tumors.
Diagnosis is made with a complete eye exam and irrigation of the tear duct; a dacryocystogram may be requested before surgery.
Treatment depends on the location and degree of the obstruction.
Opens partial obstructions.
Corrects a narrow tear punctum.
Silicone tube intubation keeps the duct open while it heals, and is removed later depending on how each case progresses.
Dacryocystorhinostomy (DCR) —external or endoscopic— creates a new drainage path between the tear sac and the nose: the external technique with bicanalicular intubation has a success rate above 90% and leaves a scar of about 1 cm that becomes nearly imperceptible over time, while the endoscopic technique is outpatient and leaves no scar on the skin.
In infants, about 11% are born with a blocked tear duct, and the great majority resolve on their own during the first year with tear duct massage; if tearing persists after 12 to 18 months, probing and irrigation is indicated. Not every case requires surgery.
After surgery in adults, recovery includes antibiotic and anti-inflammatory drops, stitch removal around one week, and avoiding physical strain for 3 weeks to 1 month.
When a procedure is needed, the cost depends on the specific case —where the obstruction is, which technique is required, and whether one or both eyes are affected— and, depending on the case, starts at 8,000 Mexican pesos; you will receive a written estimate after your evaluation. If you have medical insurance, surgery may be done through direct billing with major insurers or by reimbursement.
Why is my eye constantly watering?
Chronic tearing (epiphora) can result from excessive tear production —due to dry eye, allergy, or blepharitis— or from an obstruction in the tear drainage system. The obstruction may be located in the puncta, canaliculi, or nasolacrimal duct. A full evaluation by an oculoplastic specialist determines the exact cause.
What does dacryocystorhinostomy (DCR) involve?
This is the standard surgery for nasolacrimal duct obstruction. It creates a new direct connection between the lacrimal sac and the nasal cavity, bypassing the blocked duct. It can be performed externally (with a small incision at the inner corner of the eye) or endoscopically (with no external incision). The success rate exceeds 90%.
Does a baby with a watery eye since birth need surgery?
Not necessarily right away. Congenital nasolacrimal duct obstruction resolves spontaneously in most cases during the first year of life with massage and medical management. If it persists after 12-18 months, lacrimal probing is recommended, which is a simple and highly effective procedure.
Does tear duct surgery leave a scar?
External DCR leaves a small scar (approx. 10 mm) at the inner corner of the eye, which usually becomes very discreet over time. The endoscopic technique leaves no visible scar on the skin. The approach is chosen based on the patient’s characteristics.
How can I unblock my tear duct?
In infants, with tear duct massage and, if it doesn’t resolve after 12 to 18 months, with probing. In adults, an established obstruction won’t clear with home remedies: it’s treated with probing and irrigation, intubation, or, more often, with dacryocystorhinostomy (DCR).
How much does tear duct surgery cost?
Not every case requires surgery: in infants, for example, it usually resolves with massage. When a procedure is needed, the cost depends on each case and, depending on it, starts at 8,000 Mexican pesos. You will receive a written estimate after your evaluation.
How do I know if I have a blocked tear duct?
The most common sign is constant tearing (epiphora) in one or both eyes, which can worsen with cold or wind. You may also notice frequent crusting, redness near the nose, or, in more advanced cases, swelling and discharge (dacryocystitis). If you notice these symptoms persistently, it’s best to get an eye exam to confirm the diagnosis.
Does a blocked tear duct clear up on its own?
In infants, congenital nasolacrimal duct obstruction usually resolves on its own during the first year of life, helped along by tear duct massage. In adults, however, it rarely clears up by itself: it generally requires probing, irrigation, or surgery (DCR), depending on the cause and degree of obstruction.
