DCR (Dacryocystorhinostomy) for Tearing

When an individual develops tearing due to acquired obstruction of the nasolacrimal (tear) duct which normally drains away the tears, a DCR procedure is usually offered. However, diagnosis of the condition must be made first, and this usually requires one or more in-office tests by the ophthalmologist, which usually involves a diagnostic irrigation of the tear drainage pathways which involves placing a small, blunt irrigating syringe just inside the initial opening of the tear duct, and irrigating fluid (water or saline) through the tear drainage system. If the nasolacrimal duct is determined to be relatively or completely obstructed, a DCR procedure is often appropriate.

Functional Eyelid Surgery

The DCR Procedure

In this procedure, the blockage is bypassed and tear drainage sac is joined directly with the lining of the nose to create a new tear drainage pathway. A small incision is usually placed approximately midway between the corner of the eye and the bridge of the nose. Tiny plastic tubes (stents) are then placed in the newly created tear drainage pathway for a few months to prevent scarring of the tear drainage ducts, which might otherwise result in failure of the surgery. The tubes can usually be removed in the office with little if any discomfort or need for anaesthesia.

Reconstructive Eyelid Surgery

Treatment of Eyelid Skin Cancers

Skin cancers may occur on the eyelids, on the nose, in the “corner” of the eye, and in the eyebrow area. In the worst cases, they may invade the orbit (eye socket) as well. They typically appear as nodules, often with pearly borders and ulcerated centre. Some patients may notice they have a sore that won’t heal which is actually a skin cancer.

Treatment of any type of skin cancer must typically follow two principles of management. The first is complete excision of the lesion, and the second is reconstructive surgery. Any type of cancer must be completely destroyed or removed in order to prevent recurrence or continued growth. In most cases, this is completed with surgical excision, unless the tumor is too large or the patient is not a good surgical candidate for any reason. In these cases, some tumour are treated with irradiation. Once the cancer is completely excised, the region of surgery must then be reconstructed. This may require simple or complex incision closures, tissue transfer procedures, and skin grafting when necessary.

Any further questions you may have as well as any additional information you may require can be discussed with our Ocular Plastic Surgery Advisor during a preliminary evaluation. This service is offered free of charge.

Once you have decided to proceed with surgery, a more in depth consultation with our Ocular Plastic Surgeon will be arranged to evaluate all aspects associated with the planned surgery.

Frequently asked questions regarding Blepharoplasty

Q: Why should I choose an ophthalmic plastic surgeon rather than a general plastic surgeon when it comes to cosmetic eye lid surgery?

A: Ophthalmic plastic & reconstructive surgeons are trained ophthalmologists who super specialise in oculoplastic surgery. Cosmetic eye surgery represents a significant portion of their training, which makes them more qualified in this field, than a general plastic surgeon who has not been trained in ophthalmology.