Tear Duct Occlusion (DSR)

Lacrimal system obstruction refers to a blockage or obstruction in the tear drainage system that can cause tears to flow involuntarily. The lacrimal system includes the tear ducts, canaliculi, lacrimal sac and nasolacrimal duct.

Common causes of lacrimal system blockage are:

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Aging: As we age, the lacrimal system may narrow, increasing the risk of blockage.

Infections: Infections such as conjunctivitis or sinusitis can cause inflammation and scarring of the lacrimal system.

Trauma: Trauma to the face or eyes can damage the lacrimal system and cause blockage.

Tumors: Tumors in the nasal cavity or lacrimal system can block the tear ducts.

Structural abnormalities: Some people are born with a narrow or blocked tear duct, which can cause problems later in life.

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Treatment of lacrimal system blockage depends on the cause and severity of the blockage. Mild cases can be managed with warm compresses and massage to help open the tear ducts. More severe cases may require surgery to remove the blockage or create a new drainage pathway for tears.


Dacryocystorhinostomy (DCR) is a surgical procedure to treat a blockage in the tear drainage system. The tear drainage system consists of the lacrimal sac, nasolacrimal duct and nasal cavity. If there is a blockage in this system, tears cannot flow properly through the eyes, causing excessive tears, infections and other problems.

During a DSR operation, a new pathway is created for tears to flow from the lacrimal sac directly into the nasal cavity. This is usually done by making a small incision in the side of the nose and removing a small amount of bone to create a passageway for the tears to flow. The surgeon may then insert a stent or tube to help keep the passageway open while it heals.

The procedure can be done under local or general anesthesia and usually takes about 1-2 hours. Recovery time varies but most patients can return to normal activities within a few days to a week.

Congenital Tear Duct Obstruction

Congenital lacrimal occlusion is a condition that occurs when the tear duct system in a newborn baby’s eye is blocked or not fully developed, leading to excessive tearing or discharge from the eye. It is a relatively common condition affecting about 5% of newborns.


Treatment of congenital lacrimal occlusion typically involves a non-surgical approach called lacrimal duct massage. This involves gently massaging the tear ducts several times a day to help open them and allow tears to drain properly. The doctor may also prescribe antibiotic eye drops or ointments to prevent infection and soothe the eyes.

If lacrimal duct massage does not solve the problem after a few weeks, a procedure called probing may be necessary. During this procedure, a thin probe is passed through to help open the tear duct. In some cases, balloon catheter dilatation or stenting may also be recommended.

Surgery is usually only considered as a last resort when other treatments have not been effective. Surgery involves creating a new pathway for tears to flow out of the eye and is typically performed under general anesthesia.

It is very important to seek medical attention immediately if your newborn baby has signs of congenital tear blockage, such as excessive tearing, eye discharge or swelling around the eyes. Early treatment can help prevent complications and improve long-term outcomes.

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