OBSTRUCTION OF LACRIMAL SYSTEM

What are the main symptoms?

 

Persistent lacrimation, secretion and infection.

What are the causes?

 

Lacrimal duct obstruction occurs when there is a barrier preventing adequate tear drainage. This may be in the form of an upper airway obstruction, such as a punctual stenosis, stenosis of the canaliculi or canaliculitis. Low obstruction is the most common cause and can occur in both children and adults.
In children, tear drainage obstruction is usually congenital (the absence of the natural opening of Hasner’s valve during birth), but usually tearing occurs spontaneously in the first weeks of life.
In adults, the obstruction can occur without a clear specific cause and is more common in females over 40.

What is the treatment?

 

In children, in most cases, the obstruction resolves spontaneously. However, when the obstruction is persistent one or more of the following may be needed: massage, antibiotics in eye drops / or oral (in case of infection) and probing of the lacrimal system. In adults, usually probing of the lacrimal system is not usually unfruitful. The only effective treatment is surgery dacryocystorhinostomy (DCR). This surgery creates a new communication between the lacrimal sac and the nasal cavity to promote drainage of tears again. The DCR may be external or endonasal.

In case of surgery where are the incisions/scars located?

 

Probing the lacrimal system leaves no scar.
In external DCR, the scar is visible and is located on the back of the nose or lower eyelid.
In endonasal DCR there is no visible scar and the approach is done endoscopically inside the nose.

What type of anesthesia is used?

 

The probing of the lacrimal system (for children) is done in the operating room under general anesthesia.
DCR is a surgery performed in the operating room, either under local anesthesia with sedation or under general anesthesia, depending on the case.

Will I have to stay overnight after surgery?

 

This surgery is performed on an outpatient basis without the need for hospitalization.

What is the recovery period?

 

The recovery period lasts usually from 7 to 10 days.

– Dra. Sara Ribeiro