Tear drainage surgery (DCR - dacryocystorhinostomy)

Information for patients from the Ophthalmology Department

This leaflet is not meant to replace the information discussed between you and your doctor, but it can act as a starting point for such a discussion or as a useful reminder of the key points.

What is a DCR?

Diagram showing the tear duct, tear sac, nasal bone, nasolacrimal duct, and nose
Parts of the tear drainage system

DCR (dacryocystorhinostomy) is an operation performed to relieve watery sticky eye.

Tears are produced naturally all the time to moisten your eye, keeping it healthy and comfortable. With each blink these tears are drained away from your eye through two small holes in the inner corner of your upper and lower eyelids. The tears pass along a very small tube, collecting in the tear sac to the side of your nose. They then pass down a duct into your nose, before draining away in to the back of your throat.

If any part of this draining pathway is blocked, your eye will water. The only effective treatment of any blockage is an operation.

What are the symptoms?

  1. A watery eye.

  2. Recurring eye infection.

  3. A painless swelling near your nose called mucocele. Firm pressure on this swelling causes white or clear mucus to discharge in to your tears. This mucocele can become infected and painful.

What tests will be carried out?

What happens during the DCR operation?

The DCR is carried out as a day surgery.

It is usually performed under general anaesthetic (you are asleep) or local anaesthetic combined with sedation (you are sedated but awake, and the area is numbed). Your surgeon will discuss the best option with you at your clinic appointment.

An incision (cut) is made to the side of your nose over the tear sac, approximately where glasses rest. A direct passage is created between the tear sac in to your nose through the bone. Part of the bone will be removed to create this passage.

A silicone tube is inserted in this new passage to make sure it does not close while it heals. This tube is left in place for six weeks and will be removed in the clinic later on. Vigorous (forceful) nose blowing should be avoided during this time.

How long will my operation take?

The operation will take one to one and a half hours, so it is not a minor operation.

How will I feel after my operation?

With the tube in place your eye may still be watery, but if your operation is successful this will stop when the tube is removed.

You will be prescribed systemic antibiotics plus eye/nose drops to use at home after your operation.

When can I drive again?

Will I have a follow-up appointment?

Yes. Your first follow-up review will be in one week in the Outpatient Department, where your skin sutures may be removed. Another visit will be arranged in six to eight weeks to remove the silicone tube.

What are the complications / risks?

What should I do if I am worried about my eye?

Please remember that most patients have a very good result from their surgery. However, if you develop any problems following your operation, please call us using one of the numbers below.