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Dr greg

INTRODUCING

DR GREG MOLONEY

MBBS (Hons), MMed, FRANZCO, FRCSC
Ophthalmologist at Sydney Eye HospitalMORE

Watery Eyes

Watery eye or epiphora is generally seen in young babies and older people. In this condition, tears accumulate due to a blockage in one or both tear drainage ducts. As a result, excessive tears trickle down the face instead of draining into the nose.

The delicate balance between tear production and loss is maintained by the lacrimal system present in the eye. However, sometimes this balance between production and drainage is disrupted. The tear drainage system may be blocked due to narrowing over time. This typically occurs at either the entry point of the system- the lacrimal punctum in the eyelid, or at the exit of the duct into the nose. If a blockage develops the excess tears trickle down the cheeks.

Treatment of epiphora (watery eyes) includes the following:

Punctoplasty

If the lacrimal punctum in the eyelid is narrowed, it may be enlarged with a simple in office procedure known as a punctoplasty. This is done under local anaesthetic and typically leaves no bruising or scarring, allowing return to work later the same day or the following day.

Dacryocystorhinostomy

If the drainage system is blocked internally at its passage into the nose, a Dacryocystorhinostomy or “DCR” procedure may be required. During this procedure a direct communication is made from the lacrimal sac into the nose, bypassing the blocked nasolacrimal duct. To achieve this the nasal mucous membrane is excised and an opening is created on the lacrimal sac and upper nasolacrimal duct (tear duct). A small piece of the lacrimal and maxilla bone is removed and an incision is made in the lacrimal sac and nasolacrimal duct. A soft silicone tube is placed to keep the tract open until healing occurs. Depending on your condition, DCR may be performed externally (through the skin) or endoscopically via the nose. Either approach is equally effective. Compared to external DCR, the endoscopic approach helps avoid external scar formation.

Probing & Syringing +/- Intubation:

Probing and syringing are performed to open up blocked tear ducts. It can be performed under local or general anesthesia as an outpatient procedure. During this procedure a thin flexible probe (wire) is inserted down the tear duct to clear any blockage.

sydney eye sydney university british columbia franzcoi royal_college anzs ascrs

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