Tears normally flow from small openings in the inner corner of the eyelids into the nose through the nasolacrimal system. There is one small opening in the upper inner eyelid and one small opening in the lower inner eyelid. Tears flow through these openings into channels which combine together and then travel down into the nose. If any part of this system is obstructed, then chronic tearing and/or discharge can result.

There are many potential causes although it is difficult to confirm the exact cause in many cases. Any form of inflammation affecting the tear drain system from start to finish may contribute to the problem. Common causes of inflammation include prior nasal or sinus surgery, history of punctal/canalicular plug insertion, use of certain eye drops, chemotherapy, and radiation. It can also be congenital in nature.

A thorough examination of your eye and lacrimal system during your consult will reveal the likely cause(s) of your tearing. The best test to determine if there is a true blockage of your tear drain is an irrigation test whereby water is injected through your nasolacrimal system to check if it flows into the nose and/or throat. The timing of flow, amount of flow, and reflux from the tear drain are all revealing in terms of the location and degree of blockage.

Surgical options depend on the degree of nasolacrimal blockage. A partial blockage may likely require dilation, probing, and stenting of your natural tear drain system. A complete blockage may necessitate a bypass of your natural tear drain system to allow the tears to drain through an alternative route into the nose. The bypass can be approached externally or internally. Options will be discussed at your consult.

6 months is recommended for complete healing prior to removal of the stent; however, as long as the stent is not causing any issues and the tearing has resolved, it can stay in indefinitely.