The lacrimal system involves tear production, as well as, the ducts that tears move through, which include the eyes and nose. Problems arise in the lacrimal system when one of two conditions occur: there are excess tearing and mucous discharge from the eye(s) or there is a decrease in drainage from the system or a combination.
Types of Lacrimal System Problems
Overproduction of tears can occur due to several different irritants. These include:
- Dry eyes
- Ocular surface irritation
- Eyelid inflammation or blepharitis
The majority of the above conditions will clear up with little or no help including treatment with artificial tears, allergy medication (pills and/or allergy eye drops); prescription antibiotic drops or ointment; or oral medications. Persistence of any of these conditions may point to more serious issues that will need to be diagnosed by a eye specialist.
Consisting of two small openings, each eye lid creates a passage way for fluids to move from the eye down through to the nose. Decreased drainage from the eye can be an indicator that a tear duct as a blockage. While it sounds contradictory, decreased drainage from the eye can cause an increase in tear production, as well as recurring eye infections.
Eye infection symptoms include a sense of warmth and/or redness between the eye and nose, discharge and an irritated (often pink) eye. To confirm the presence of a blocked tear duct, a physician will irrigate a saline solution through the duct system. Common solutions to a blocked tear ducts are steroid drops or, if the blockage is severe, surgery.
Lacrimal Surgery Types
Depending on the severity of the lacrimal problem (i.e. blockage), there are a variety of surgery options, including:
- Probe and tube
- Dacryocystorhinsotomy (DCR)
- Conjunctivodacryocystorhinostomy (CDCR)
Punctoplasty is fairly uncomplicated and performed in the physician’s office under a local anesthetic. The doctor will dilate the small openings (puncta) of the tear duct with a small instrument and make a small incision to open the duct further allowing for increased drainage. The patient may experience some minor swelling; however, they can, typically, resume normal activity immediately.
Probe and tube, DCR and CDCR are all surgical procedures technically speaking. However, probe and tube is fairly uncomplicated and takes approximately 15 minutes.