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Nose Surgery

Endoscopic DCR — a new tear-drainage path, no facial scar.

When the tear duct is blocked, tears spill onto the cheek instead of draining into the nose. Endoscopic DCR creates a new direct opening between the tear sac and the inside of the nose — through the nostril, with no facial incision. The watery eye stops watering, usually within weeks.

Medical nameEndoscopic Dacryocystorhinostomy
Duration45–75 minutes
AnaesthesiaGeneral
ApproachEndoscopic
In-clinic ENT surgical setup In-house surgical practice · Dr. Naseer's ENT

Overview

Tears normally drain from the corner of the eye through a small duct into the nose. Blockage of that duct — usually idiopathic, occasionally infective — causes a persistently watery eye and recurrent infections of the tear sac (dacryocystitis).

External DCR (through a skin incision near the nose) gives excellent results but leaves a small scar. Endoscopic DCR achieves the same outcome through the nostril and is now preferred in most cases.

When This Surgery Is Recommended

  • Persistent watery eye from a blocked nasolacrimal duct
  • Recurrent dacryocystitis or sac abscess
  • Failed lacrimal probing or silicone-tube intubation
  • Patient preference to avoid an external skin scar
  • Bilateral disease where two sides can be done in one session

The Procedure

Done under general anaesthesia, usually with the ophthalmologist working alongside for tear-system access.

  • The nasal endoscope identifies the bone overlying the tear sac
  • A small window is created in the bone
  • The tear sac is opened and stitched to the nasal lining
  • A soft silicone tube is sometimes placed to keep the opening patent
  • The tube is removed in clinic at 6–8 weeks

Pre-Surgery Preparations

  • Pre-op ophthalmology consult and lacrimal probing/imaging
  • Continue ophthalmic drops till the morning of surgery unless told otherwise
  • Fast 6 hours pre-op
  • Stop blood thinners 5 days before with clearance
  • Saline rinses started 24 hours before to clean the surgical field
  • Companion arranged for transport home

Post-Surgery Recovery

  • Same-day or overnight stay
  • No facial bandage or external scar
  • Saline rinses for 2 weeks; eye drops for 1 week
  • Office work in 5–7 days
  • Watering improves over 2–4 weeks; full effect by 2–3 months

Follow-up Schedule

  • Day 1 — dressing and eye care reviewed before discharge
  • Week 1 — nasal endoscopy and silicone stent position check
  • Week 6 — silicone stent removed in clinic
  • Week 12 — tear-drainage syringing and symptom score
  • 6 months — durability check jointly with ophthalmology

Potential Complications

  • 85–95% success in published series
  • Failure from scarring of the new opening — manageable with revision
  • Minor bleeding from the nose
  • Temporary mild bruising around the eye in some patients
At Dr. Naseer's ENT, we work this up carefully with the eye team to make sure DCR is the answer your watering eye actually needs.

Why Have It Here

Endoscopic DCR is precision work in a millimetre-scale field with both nasal and ophthalmic landmarks. We work the case up properly first — sometimes the watering has an upstream cause that won't be fixed by surgery alone.

Have questions about Endoscopic DCR? Let's talk before you decide.

Book consultation 070130 29818