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Oculoplastic Surgery

Tear Duct Surgery

Tear ducts start with two small canals inside the lower and upper eyelids, form the tear sac and open via a thin canal into the nasal cavity, where they terminate. The main purpose of tears is to protect the eyes against foreign bodies and ensure the continuous lubrication and clearness required for eye health. The front side of the eye is continuously washed by tears. This washing fluid and the harmful substances on the surface of the eye are transferred through the tear canal into the nose and then into the throat. Obstructions in this path cause watering and eye discharge. Tear duct surgery is the branch of surgery which deals with diseases of this area.

Eye Dryness

Symptoms of eye dryness change depending on the severity of tear deficiency. They can vary from small complaints like occasional mild burning, watering and redness to serious conditions which may severely damage the quality of vision and life. In mild cases, treatment consists of artificial teardrops which are intended to replace the deficiency. Severe eye dryness requires different, more serious treatments.

Acquired Lacrimal Duct Occlusions

The causes of tear duct occlusions which are not congenital are usually unknown. The occlusion is located at the intersection of the tear sac and the canal. It is more common in women. Surgical treatment is applied.

Congenital Lacrimal Duct Occlusions

Tear ducts continue to develop after birth. In some infants, symptoms like watering and eye drainage may occur when duct development is not completed after birth. Different treatments are required depending on the patient’s condition.

Treatments for Lacrimal Duct Occlusion


Lacrimal duct occlusion causes watering and inflammation. If the duct has not been cleared by the time the child turns 1.5 years old, a method called probing is used. It is performed under general anesthesia and lasts about 5-10 minutes. Entry is made with a probe into the upper end of the tear duct and the blockage in the lower end is cleared. There is a 90% chance of success. Success is less likely after 2 years of age.


Surgical Intervention (DCR) 

In adults, instead of clearing a blocked duct, a new path is opened between the tear sac and the nose. The surgery can be performed through the skin or the nose. When performed through the skin, surgery is more likely to be successful (nearly 95% chance of success) and leaves no unpleasant scars on the skin.


Multidiode Laser (Treatment of Lacrimal Duct Occlusion with Laser)

Many new techniques are employed to clear lacrimal duct occlusions today. Having been used for the last few years in the US and several European countries, the new generation Multidiode Laser offers a fast solution for tear duct surgeries with topical anesthesia, without bleeding or scars.


Lacrimal System Tumors 

Lacrimal gland tumors are more common than tumors of the tear drainage system. Prevalence is higher in adults. Treatment changes according to the type of tumor.

Watery Eyes 

Watery eyes result either from too much tear production or from drainage slowing down or stopping. Increased tear production has several causes. Watery eyes are resolved when the causal factor is eliminated. 

Tear Duct Injuries 

They are often accompanied by eyelid injuries. If appropriate treatment is not applied at an early stage, permanent obstruction of tear ducts may lead to constant watering and eye discharge. The condition should be seen by an ophthalmologist and the disorder caused by trauma in the tear ducts should be corrected.

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