Stopping Excess Tearing

Watery EyesTears have an important job — lubricating, nourishing, and protecting the front of the eye. But their path, from origin across the eye and then out through the nasal passage, is a long one and has numerous spots when the flow can become disrupted. When this happens there in an overflow of tears, clinically called epiphora. Dr. Shams can correct this condition with dacryocystorhinostomy (DCR).

Whoa. That word would be a good one for Wheel of Fortune if you bought an O, but for the rest of us, let’s just say DCR is basically necessary to correct drainage failure in the eye or eyes. As an oculoplastic surgeon, Dr. Shams is expert at correcting epiphora.

What tears are made of

Tears have three main components: the lacrimal gland produces a watery component; glands in our eyelids produce an oil component; and other cells produce mucus. These three components work together to create a film that covers the white of the eye and the cornea. When we blink, this film is wiped across the eye by the eyelids.

If insufficient tears are produced, our eyes become sore and dry. If excess tears are produced, or if those tears cannot exit the eye into the nose, the eyes become watery/teary.

The path

After tears are produced in the lacrimal glands, they cross the eyes through blinking. From there, tears are directed into small openings in the eyelids called puncta. They then move into the lacrimal sac, located between the eye and the nose, which funnels the tears into the nasal cavity through the nasolacrimal duct.

Problems occur along this pathway, which lead to excessive tearing. Blockage of the nasolacrimal duct is one common cause. This blockage can occur from trauma, prior surgery, tumors, or inflammatory medical conditions, but the conditions are usually difficult to pinpoint. Creating a direct opening from the lacrimal sac into the nasal cavity can solve this blockage. This procedure is DCR.

The DCR procedure

Dr. Shams performs this procedure to open a pathway from the lacrimal sac directly into the nose, bypassing the blocked nasolacrimal duct. To do this, there are two basic methods: external or endoscopic. In external DCR, the lacrimal sac is accessed through a small incision between the eye and the nose, and then an opening is created into the nasal cavity.

Endoscopic DCR does the same thing, but the incision is made within the nose using an endoscope. This is the preferred method of Dr. Shams because it doesn’t leave any visible scarring and is generally less painful. Bone is often removed from the area over the lacrimal sac and then the sac is opened into the nose. Dr. Shams may place a stent to maintain the opening over time.

If you suffer from excess tearing, you may have a blocked nasolacrimal duct and may need DCR. Call Dr. Shams to set up a consultation.

Posted in: Watery Eyes

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My NHS practice is based at the world-renowned Moorfields Eye Hospital in London. I consult private patients at Moorfields Private Eye Hospital, Weymouth Street Hospital, Phoenix Hospital Group Outpatient Centre and The Harley Street Clinic.

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