If you have a watering eye, I can carry out an examination to determine whether this is due to a blocked tear duct.
The only treatment for this condition is surgery. No other treatment works. You need to come to a decision about whether the watering eye bothers you enough that you would go through with an operation. We will discuss the success rates, benefits and risks of surgery. If you are certain that you do not wish surgery, no further tests are necessary and you can be discharged from the clinic.
If you decide that you do wish surgery then further tests may be necessary. These will help to confirm the nature of the blockage.
DCG (dacryocystography).
An X-ray is taken in the region of the eyes and the nose while contrast medium is injected down the tear ducts. Another X-ray is taken some minutes later to check if the contrast has passed into the nose.
Lacrimal scan.
A drop of radioactive material is placed in the eye and its progress down the tear duct followed using a gamma-camera.
Neither test should be carried out if there is any chance that you could be pregnant.
The operation for a watering eye is called a DCR (dacryocystorhinostomy). This is carried out under general anaesthetic. An incision is made in the side of the nose and bone is removed between the eye and the nasal space. The lining of the tear duct is sutured to the lining of the nose to bypass the blockage. A silicone tube is placed from the inner corner of the eye to the nostril to keep the new duct open while it heals.
The stitches are removed in one week.
The silicone tube is removed at 6-12 weeks by cutting it at the eye and pulling it down the nose.
The success rate is 90% in complete blockage and 70% in partial blockage.
X-rays and surgery may need to be repeated if the first operation is not successful.
Remember. A watering eye will not damage your sight so no doctor can tell you that you need an operation. The decision is yours.
John Pitts is an oculoplastic surgeon in full-time private practice in London and Barbados following a substantive NHS consultant position. He graduated MB ChB from Glasgow University in 1983 and, in 1987, after working in pathology and neurology, he trained in ophthalmology in Glasgow, Nottingham and London. He has travelled extensively, working in centres of excellence in Los Angeles, New Orleans, Melbourne, Barbados, Brunei and Vancouver. He has undertaken Fellowship training in oculoplastics at Moorfields Eye Hospital.
