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Dacryocystorhinostomy (DCR), also known as watering eye surgery, is an operation that makes a new passage for your tears to pass from your eye to your nose.
It aims to stop fluid and mucus blockage within the lacrimal sac (your tear sac) and increase tear drainage for the relief of epiphora (watering eyes).
This procedure is also known as lachrymal surgery, or a tear duct bypass surgery. There are two ways of performing watering eye surgery:
- External dacryocystorhinostomy (DCR) - performed through a small incision on the side of the nose
- Endoscopic dacryocystorhinostomy (DCR) - performed from inside the nostril, so no scars are visible
You might need this type of watering eye surgery if your eye is so watery that it's becoming disruptive or if you are experiencing frequent infections in your eye or tear duct.
This procedure won't be the right choice for everyone with watery eyes. Other available treatments include:
Puncto-canaliculoplasty surgery: another form of watering eye surgery
Puncto-canaliculoplasty surgery is another form surgery performed to treat watering eyes. It typically treats less severe cases of watering eyes, caused by a condition called punctal stenosis.
The procedure is a minor surgery to enlarge your punctum (the opening of your tear duct drainage system).
If your punctum narrows or becomes blocked, your eyes will likely flow with tears. Your punctum usually narrows due to inflammation of your upper or lower eyelids.
Punctoplasty is a relatively short procedure and is typically performed using local anaesthesia . It has high success rates for people suffering the effects of a narrowed punctum or punctums.
Speak with your consultant to determine whether this surgery is the best form of treatment for you.
Punctal plugs for dry eyes
This is a potential treatment option if you have chronic dry eye, which can cause itchiness and irritation of the eyes. Dry eye can even cause blurred vision.
Punctal plugs are small biocompatible devices that can be inserted into your tear ducts to block drainage and relieve certain forms of dry eye. The procedure is non-invasive and can be performed under local anaesthetic.
Temporary punctal plugs can be inserted to determine whether the treatment works for you. If it does, you can opt for permanent punctal plugs, which can last for years.
Temporary punctal plugs usually dissolve over a period of three months. Permanent punctal plugs do not dissolve, but they can be removed quickly if needed.
Speak with your consultant to determine whether punctal plugs are the best possible treatment option for you.
Most external DCR operations are carried out under local anaesthesia and as a day procedure. This means you will be awake and you won’t need to stay overnight in hospital.
During an external DCR, your consultant will make a small cut on the side of your nose to access the tear sac. A piece of bone between the tear sac and your nose will be removed to reach the inside of your nose.
The tear sac is opened and stitched to the lining of the nose. This forms a direct passage between the sac and your nose.
A soft silicone tube or thread may be put into the tear passage to keep it open during healing.
External DCR surgery takes around one hour to 90 minutes.
Most endoscopic DCRs are performed under general anaesthesia . This means you'll be asleep for the procedure. You may need to stay overnight in hospital but that won't always be the case.
In this operation, your consultant will access the inside of your nose by using a small telescopic instrument called an endoscope. This will allow your consultant to see inside your nostril and make a small opening between the tear sac and the lining of your nose, without using stitches.
The opening is smaller than with an external DCR and the operation is usually quicker. There is no cut in the skin for an endoscopic DCR operation.
Your consultant will place silicone tubing into the tube passage to keep this open.
If you have local anaesthetic, you should be able to leave hospital a few hours after the procedure.
If you have general anaesthetic, you will usually stay for one night to recover before returning to your regular activities.
After both types of DCR procedures, you will receive eye drops to use for a few days and detailed aftercare instructions explaining how to make the most of your recovery. You might feel discomfort around the corner of your eye, but this should settle.
You will need to return to the clinic several times after the operation so that your consultant can carefully monitor and manage your recovery.
The cost of your surgery depends on which hospital you have surgery in and who you have surgery with.
Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.
Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over one to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.
If you have private health insurance, watering eye surgery will usually be covered by your provider. Speak to your insurer directly to find out.
At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:
- Flexible appointment times and locations that are convenient for you
- The freedom to choose which hospital and consultant suit your needs
- Personalised, consultant-led treatment plans tailored to your individual needs
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private ensuite rooms as standard
- A range of delicious healthy meals
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to see a consultant or learn more about dacryocystorhinostomy or any other treatment for a watery eye, book your appointment online today or call a member of our team directly.
Content reviewed by Circle in-house team in March 2023. Next review due March 2026.
- Dacryocystorhinostomy: Treatment for a Blocked Tear Duct, Johns Hopkins
- Dacryocystorhinostomy, American Academy of Ophthalmology
- Surgery for a watery eye, NHS
