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Tearing and Lacrimal Disorders


Tears are made in the outside corners of the eyes, travel across the surface of the eye, and are absorbed by four very fine tear ducts that drain into the nose. Any abnormality in this process can prevent normal tear flow and cause teary, itchy, or watery eyes. When severe, this can even lead to infections in the tear sac or face. This may be caused by allergies, trauma, radiation or certain medicines used to treat cancer; tearing may often be present with no discernible cause.

Treatment is dependent on the reason for the tearing. Tearing can be from a combination of 3 causes – excessive tear production, poor tear pump function, or insufficient tear drainage. Tear production excess occurs in corneal diseases such as dry eye or blepharitis or eyelash disorders. Tear pump disorders occur when there is incomplete eyelid closure from facial paralysis, ectropion, or facial scarring. Tear drainage disorders block proper tear outflow. This requires detailed evaluation to assess and determine the root cause. We look forward to working with you to evaluate and tailoring treatment to your specific condition.

How is surgery performed?

Surgery is typically performed with an endoscope (scarless technique), so that no incisions are necessary on the face. Very rarely, Dr. Ramesh may need to make an incision on the skin in cases of tumor or other unexpected conditions. This incision camouflages well into the normal smile lines of the face.

Surgery may be performed under general or twilight anesthesia. Patients can have bruising and swelling around the eyes for 1-2 weeks, with minimal pain. Patients are typically ready for formal social functions within 6 weeks.

Does insurance cover surgery?

Health insurance typically covers the majority of the treatments for tearing. Please schedule a consultation so that we can check what your insurance will cover.

Are there any side effects to surgery?

Tear duct surgery is typically 97% successful on the first attempt. Patients may experience light nose-bleeding and bruising after surgery which resolves in the following days. Fortunately, the risk to the eye or nose from this type of surgery is very rare.

What is the aftercare?

There are no patches, bandages, or dressings to the eyes after surgery. Dr. Ramesh may place a temporary stent to the tear duct to allow proper healing after surgery, which can be removed in the office without any discomfort. Dr. Ramesh will prescribe you antibiotic drops and a nasal spray to aid in healing.

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    The Center for Eye and Facial Plastic Surgery
    35 Clyde Road, #104
    Somerset, NJ 08873
    Monday – Friday: 8:30a – 4:30p

    Livingston Office
    22 Old Short Hills Rd Suite 202
    Livingston, NJ 07039
    Monday: 9:00a – 5:00p
    Tuesday: 12:00p – 7:00p
    Wednesday – Friday: 9:00a – 5:00p

    P: (609) 608-0142
    F: (855) 644-0469

    Contact Us 609-608-0142