dcr tears still

[michelle49]

I had the dcr surgery over a year ago.  I started having tearing again so I went back to my Dr.  He tested the sac by injecting some kind of fluid and told me it was not blocked.  I am still having the tearing.  He does not know what it could be.  I went to another Opthamologist and he gave me a perscription for some eye ointment and told me to use it for 3 weeks.  I did and my eye is still tearing.  Could this have something to do with my sinisus?
My eye does not itch.  I am unsure what to do next.  I would like the tearing to stop!
Thank you

[BA17]

What are permanent stents.  I already have tube in my tear ducts and this is not helping.  Is that what a permanent stent is?

[BA17]

I too have had DCR surgery on both of my eyes and they are both still tearing.  I was taken off all drops of which I was on several over the years and now my eyes are red and teary.  Quality of life is poor under these conditions.  My doctor suggested doing the endoscopic probe but I think I would like another opinion from a credible hospital like Wills Eye.  Any thoughts on this?

[John C Hagan III, MD, FACS, FAAO]

Yes, steroids can often save the day and prevent a further surgery especially if the sac/tube system has been irrigated or dilated.

JCH III MD

[michelle49]

Thank you for your reply.  No he did not take a tissue biopsy to rule out sarcoid.  I will suggest that be done.  Have you had experience with this problem where steriods help decrease the inflamation and maybe open up the sac?
Thank you for your help.

[John C Hagan III, MD, FACS, FAAO]

Use the Find An Eye MD feature on the website of the American Academy of Ophthalmology  www.aao.org to find a board certified oculo-plastic surgeon in the Cleveland area.

Did he take a tissue biosy to rule out sarcoid? I would get the problem a couple of months more to see if the steroid and irrigation help.

Good luck.

JCH III MD

[michelle49]

I went back to my Eye MD who is a Ocul-Plactic surgeon who did the 2nd DCR back in 2005.  This time when he injected fluid into the tear sac it was blocked.  He then looked up my nose and did notice some inflamation. He thought I may have sarcoidosis.  He prescribed Methylprednisolone and a cortisone ointment used only at bedtime.  He said that I should come back in 3 weeks.  If I continue to have tearing, he said my alternatives are to have the surgery again and put a permanent stent into the tear sac.  If I find that this is my only option, I would like to seek another opinion.  Have you any other thoughts on this matter>  Do you know any Ocul-Plactic surgeons in the Cleveland Ohio area that are excellent in their field?  Your help is appreciated.

[John C Hagan III, MD, FACS, FAAO]

A nasal endoscope is an instrument to look up into the nose to see if the opening created from your tear sack into the nose is still open. Putting a stent in your tear sac would involve minor surgery done in the office. Normally no shots or stitches are necessary.

JCH III MD

[michelle49]

Once you have had dcr surgery, can you have a stent put back into the tear sac without additional surgery?
Thank you.

[michelle49]

What is endo nasal endoscopic surgery and is it painful?

[John C Hagan III, MD, FACS, FAAO]

Hello Michelle.  IF your problem is just one eye tearing and its the one with the previous dacryocystorhinostomy it's NOT like allergy or poor quality tears. It IS most likely related to your tears not draining well. Injecting fluid into the tear ducts under pressure is not a true physiologic test of drainage. It only tell if there is an absolute obstruction. Your tears do not go into the tear duct under any where near the pressure that the irrigating syringe creates.

My advise would be to obtain a second opinion from an Eye MD physician that specializes in Ocul-Plastic surgery. They need to look up your nose with an endoscope after doing a dye disappearance test.

You might benefit from endo-nasal endoscopic surgery, a one snip procedure, or putting a stent into the tear sac for several months.

JCH III MD Eye Physician & Surgeon