The treatment of watering eyes is entirely dependent on its cause.
Blepharitis or dry eye
If the cause of the watering eye is blepharitis or dry eye, with ocular irritation and reflex tearing, this is treated non-surgically with eyelid hygiene, lubricant eye drops (artificial tears) and occasionally antibiotic creams or tablets.
If the cause is dacryocystitis, with a painful swelling of the lacrimal sac due to a blocked tear duct, it will be treated initially with oral antibiotics for five days after which a DCR will be done. DCR consists of making a permanent surgical opening from the lacrimal sac into the nose, through which the tears will then drain freely, resulting in relief of the watering eye symptoms.
Blocked tear duct
If the cause of the watering eye is a blocked tear duct (nasolacrimal duct) the choice is then to have a DCR done through the nose, or an external approach DCR (through the skin), or a combination of the external approach with endoscopic endonasal monitoring.
At the end of the DCR surgery, soft silicone tubes are placed between the corner of the eye and the inside of the nose, which are then removed approximately 4-6 weeks after surgery.
The success rates for both endoscopic endonasal DCR and external DCR are in the range of 85% to 95%. However, if the cause is more complicated than a simple obstruction of the nasolacrimal duct, this figure can indeed be lower.
Clinica London specialises in endoscopic endonasal lacrimal DCR surgery
At Clinica London, Jane Olver specialises in endoscopic endonasal lacrimal DCR surgery. She also has pioneered Light Tears where she uses an external approach curvilinear skin incision hidden in the tear trough to access the lacrimal sac, together with the endoscope inside the nose for both illumination and to assist navigation during the surgery. This combined approach, of combined external and endoscopic DCR (CoExEn), provides results between 95% and 100%.
Jane Olver specialises in carrying out surgery on patients who have failed previous DCR surgery, who have had complicated trauma, previous sinus surgery and other diseases. She uses a special external and endoscopic approach, with fine intranasal instruments to delicately recreate an opening between the sac and the nose, to enable tear drainage.
If the cause of the watering is a blockage of the fine tear ducts (canaliculi) then the DCR is done first, with subsequent insertion of a small glass bypass tube, called the Jones’ tube, under local anaesthetic a few weeks later. This is a permanent bypass tube which has very good results, but with the inconvenience of the tube.