Blocked Tear Duct Surgery

Medically reviewed by: Op. Dr. Alim Hüseynov · Last updated: 7 September 2026

Blocked tear duct and DCR surgery

Tears are produced continuously, spread over the eye surface and drain through the puncta into the lacrimal sac and then into the nose. When this drainage pathway is obstructed, tears overflow onto the cheek and the stagnant sac can become infected.

Symptoms

• Constant watering, worse in wind and cold
• Discharge and crusting at the inner corner
• Swelling, redness and pain over the lacrimal sac (dacryocystitis)
• Blurring caused by the tear film, and repeated conjunctivitis

Assessment

Examination includes eyelid and punctal inspection, tear film assessment, syringing and probing of the drainage system to locate the level of obstruction, and imaging such as dacryocystography or CT where the anatomy needs to be defined. Watering is not always caused by blockage — dry eye, eyelid malposition and blepharitis can produce the same complaint, and treatment differs entirely.

Treatment

• Infants: congenital obstruction often resolves in the first year with massage and hygiene; probing is considered if it persists.
• Punctal or canalicular narrowing: punctoplasty or intubation with a silicone tube.
• Nasolacrimal duct obstruction: dacryocystorhinostomy (DCR) — a new passage is created between the lacrimal sac and the nasal cavity.

External and endoscopic DCR

External DCR is performed through a small skin incision beside the nose and has a long record of high success. Endoscopic DCR is performed through the nostril, leaving no skin incision. The choice depends on the anatomy, previous surgery, the state of the nose and the presence of infection or a lacrimal sac tumour. A silicone tube is usually left in place for a period and removed in clinic.

Recovery

The procedure is generally day-case. Mild bruising and nasal congestion are expected for a few days; nose-blowing is avoided in the early period. Antibiotic and anti-inflammatory drops and nasal spray are used as prescribed. Watering usually improves quickly once the passage is open.

Frequently asked questions

Does a watering eye always mean a blocked duct?

No. Dry eye, eyelid malposition and blepharitis cause the same symptom, so the drainage system must be tested.

Does external DCR leave a visible scar?

A small incision beside the nose is used and usually settles to a barely visible line. Endoscopic DCR leaves no skin incision.

How long does the silicone tube stay in?

Usually a period of weeks to a few months, decided by your surgeon; it is removed in clinic.

Is my babys watering eye treated the same way?

No. Congenital obstruction often resolves in the first year with massage and hygiene; probing is considered if it persists.

Medically reviewed by

Op. Dr. Alim Hüseynov — Ophthalmologist — refractive laser surgery, cornea and oculoplastic surgery, Nişantaşı Hastanesi Göz Merkezi. Our doctors

This page is for general information and does not replace an examination by a doctor. Treatment decisions are made after examination and diagnostic tests.