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Tear Drain Reconstruction

Problems with Tearing

Too little or too many tears are very common problems and may occur together in some patients. The tears, produced by the main and accessory lacrimal glands, serve to lubricate the surface of the eye. Excess tears are directed from the surface of the eye into a tear drainage system located at the inside corner of both the upper and lower eyelids. This drainage system passes through bone and into the inside of the nose.

What is Dry Eye?

Patients with insufficient tear production may experience the sensation of grittiness, pain, and light sensitivity on the surface of the eyes. Patients may intermittently make too many tears in an attempt to relieve the irritation on the surface of the eyes (reflex tearing or lacrimation) and these tears may overwhelm the tear drainage system leading to overflow of tears down the cheek.

Treatment of dry eye and reflex tearing is directed at improving the health and stability of the tear film and surface of the eye and may involve artificial tears, anti-inflammatory drops, eyelid hygiene, oral medications, purposeful blockage of the tear drainage system (punctal plugs), or surgery designed to address any abnormal eyelid position or function.

What are Blocked Tear Ducts?

Blockage of the tear drainage system may lead to tears overflowing the eyelids (epiphora), or infections that can vary from mild to severe (canaliculitis or dacryocystitis). Blockage can occur at the opening of the drainage system (punctum), in the small passageway in the eyelids (canaliculus), in the tear sac (lacrimal sac), or through the bony passage into the nose (nasolacrimal duct). A blockage may occur from trauma, plugs, infections or inflammation or from age. Surgical correction of the tear drainage system is directed at re-establishing an open and functioning tear drainage system and may involve opening the punctum (punctoplasty), repairing the canaliculus, or diverting tears from the lacrimal sac into the nose through a new passageway. (Dacryocystorhinostomy or DCR).

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