- Medically Reviewed by Mr Mfazo Hove Consultant Ophthalmologist
- Author: Chris Dunnington
- Published: April 30, 2025
If you’re struggling with a blocked tear duct, you may have been advised to consider tear duct surgery known as dacryocystorhinostomy (DCR). At Blue Fin Vision® Eye Clinic, with locations in London, Chelmsford, and Hatfield, we specialise in both External Dacryocystorhinostomy (DCR) and Endoscopic Dacryocystorhinostomy (DCR). This guide explains the differences between these procedures, helping you make an informed decision about your care.
Understanding Dacryocystorhinostomy (DCR)
DCR is a surgical procedure that creates a new drainage pathway for tears when the natural tear duct becomes blocked. This resolves symptoms such as:
- Constant watery eyes (epiphora)
- Recurrent eye infections
- Swelling or pain near the inner eye corner
- Sticky discharge from the eye
At Blue Fin Vision®, our expert surgeons tailor their approach to your needs, whether through external DCR or endoscopic DCR.
What is External Dacryocystorhinostomy (DCR)?
External DCR is the traditional surgical method for treating blocked tear ducts.
Key Features:
- A small incision (10–15 mm) is made on the side of the nose near the inner eye.
- The surgeon directly accesses the tear sac to remove the blockage and create a new drainage channel.
- A temporary silicone stent may be placed to support healing.
- The incision is closed with fine sutures, leaving a faint scar that typically fades over time.
Advantages:
- Excellent success rate of approximately 90%, making it the gold standard for many patients.
- Direct visualisation allows precise correction of anatomical issues.
- Suitable for patients with previous nasal surgery or trauma.
Considerations:
- Minimal scarring, though a faint line may remain.
- Recovery may take 2–3 weeks, with mild bruising or swelling.
What is Endoscopic Dacryocystorhinostomy (DCR)?
Endoscopic DCR is a minimally invasive alternative performed entirely through the nostril.
Key Features:
- No external incision – a thin endoscope and instruments are inserted via the nose.
- The surgeon creates a new drainage pathway using high-definition imaging.
- A silicone stent may be used temporarily to maintain the opening.
Advantages:
- No visible scarring, ideal for scar-conscious patients.
- Faster recovery (1–2 weeks) with minimal discomfort.
- Can address nasal issues (e.g., deviated septum) during the same procedure.
Considerations:
- Typical success rates are 85–90%, which is slightly lower than the external approach.
- Requires specialist expertise and advanced equipment.
- May be less suitable for complex or recurrent blockages.
Comparing External DCR vs Endoscopic DCR
- Surgical Approach
- External DCR: Involves a small external incision near the nose.
- Endoscopic DCR: Performed internally through the nostril.
- Scarring
- External DCR: Leaves a discreet scar that fades over months.
- Endoscopic DCR: No external scarring.
- Recovery Time
- External DCR: Full recovery typically takes 3–4 weeks.
- Endoscopic DCR: Most patients resume normal activities within 1–2 weeks.
- Success Rates
- Both procedures have high success rates when performed by experienced surgeons.
- External DCR: Excellent, around 90%.
- Endoscopic DCR: High, typically 85–90%, which is slightly lower than the external approach.
- Suitability
- External DCR: Recommended for recurrent blockages, trauma cases, or anatomical abnormalities.
- Endoscopic DCR: Ideal for first-time surgeries or patients prioritising no scars.
Why Choose Blue Fin Vision® for Your DCR Surgery?
- Expertise in Both Techniques
Our oculoplastic surgeons are highly skilled in external DCR and endoscopic DCR, ensuring you receive the most appropriate treatment.
- Personalised Care
We consider your medical history, lifestyle, and preferences to recommend the best approach.
- State-of-the-Art Facilities
Our clinics in London (Harley Street and Weymouth Street), Chelmsford, and Hatfield are equipped with advanced technology for precise diagnosis and surgery.
- Comprehensive Aftercare
From stent removal to follow-up consultations, we support you at every stage of recovery.
Addressing Common Concerns
Will external DCR leave a noticeable scar?
Our surgeons use cosmetic techniques to place the incision in natural skin creases. Most scars become barely visible within 6–12 months.
Is endoscopic DCR less reliable?
Endoscopic DCR typically achieves success rates of 85–90%, which is slightly lower than external DCR, but offers the benefit of no visible scarring. For straightforward cases, outcomes are excellent.
Which procedure is less painful?
Both are performed under anaesthesia, ensuring comfort. Discomfort post-surgery is typically mild and manageable with medication.
Your Journey to Clear Vision Starts Here
At Blue Fin Vision®, we pride ourselves on delivering patient-centred care tailored to your needs. Whether external DCR or endoscopic DCR is right for you, our team ensures:
- Clear explanations of risks, benefits, and aftercare.
- Prompt appointments at our London, Chelmsford, or Hatfield clinics.
- Transparent communication throughout your treatment.
Don’t let a blocked tear duct disrupt your life. Book a consultation today to explore your options with our expert surgeons.
Trust your vision to Blue Fin Vision® – where advanced tear duct surgery meets compassionate care. Let us guide you towards lasting relief from watery eyes and recurrent infections.
