The lacrimal system is a crucial structure responsible for producing, distributing, and draining tears, which are essential for maintaining eye health, lubrication, and protection. Disorders of the lacrimal system can lead to discomfort, vision problems, and other complications. These disorders may affect tear production, distribution, or drainage.
Nasolacrimal duct obstruction (NLDO) is a condition where the tear drainage system is blocked, leading to symptoms such as excessive tearing, discharge, and recurrent eye infections. Initial treatments for NLDO include dacryocystorhinostomy (DCR), a surgical procedure that creates a new pathway for tears to drain into the nose. However, in some cases, the initial surgery may fail, and patients may continue to experience symptoms. Revisional surgery is then required to address the underlying issues and restore proper tear drainage.
Tears and eye health form a functional whole. The tear duct normally opens into the nose. Obstruction most often occurs in the area where the duct opens into the nose (nasolacrimal duct). It is more common in women and the elderly. It causes complaints such as watery eyes, crusting, and blurred vision. In some patients, the tear sac may enlarge and cause swelling in the inner-lower part of the lower eyelid. Sometimes, severe inflammation of the sac spreading to half of the face may develop (“acute dacryocystitis”). If the fluid given to the tear duct does not go to the patient’s throat or only passes in small amounts, it indicates that the duct is blocked. The treatment is surgery. Medication is useless. In surgery, a new tear duct is created from a level above the obstruction. (“Dacryocystorhinostomy”, “DCR”) This procedure can be performed intranasally or through the skin. The success rate of surgery through the skin is higher. 95-98% of patients recover after the first surgery. There is a higher probability of re-blockage after laser and intranasal surgeries. Surgery through the skin can be performed with new techniques, without leaving a noticeable scar on the skin. Surgery is performed with local anesthesia in most patients, and the patient is discharged the same day. Unsuccessful tear duct surgeries. Patients who have previously undergone tear duct surgery and whose surgery was unsuccessful may get rid of their complaints after a second intervention. Second tear duct surgeries are often performed by ophthalmologists who are experienced in this field and ophthalmologists who are competent in the field of oculoplastic surgery. If necessary, your ophthalmologist will refer you to an experienced oculoplastic surgeon for this purpose.
It is a common problem in babies. It is usually due to the presence of a membrane in the area where the tear duct opens into the nose. It causes watering and frequent crusting in the eyes. Some babies may develop a swollen tear sac. In treatment, methods such as tear sac massage, lacrimal probing, silicone tube placement and dacryocystorhinostomy are used depending on the patient's age and clinical findings. The results of the surgery are extremely successful. One surgery is sufficient for the vast majority of patients. Treatment options are not exhausted in patients whose watering continues despite previous probing or silicone tube placement. In these patients, tear duct surgeries are also extremely successful, in proportion to the experience of the physician.
Turkey has become a leading destination for the diagnosis and treatment of lacrimal system disorders, offering high-quality medical services at affordable prices.
Lacrimal system disorders can significantly impact eye health and quality of life. Early diagnosis and appropriate treatment are essential for managing these conditions effectively. Turkey offers an excellent combination of skilled specialists, advanced technology, and affordable prices, making it a top choice for patients worldwide.
Tips for Patients:
Op. Dr. Ayşe Dolar Bilge
Ophthalmologist
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