Plastic Surgery


It is important to evaluate tearing because it can lead to the identification of a problem with tear production or tear drainage.


Tearing can be due to several factors and a complete tearing evaluation can identify the causes. There are several tear producing structures within the eyelid. Under certain conditions, the cornea and eye do not contain sufficient lubrication and subsequently, the glands are triggered to produce more tears. As a result of the increased tears, the drainage system might not be able to accommodate the increased amount of tears and symptoms of tearing result.


A major cause of tearing is insufficient drainage of the tears. Drainage of tears relies on several anatomical structures: eyelid, lacrimal punctum and nasolacrimal duct. These structures must work together in order to maintain proper drainage. A dysfunction in any of these structures can result in tearing.

Treatment Options

During the evaluation, a procedure called probing and irrigation of the lacrimal duct may be performed. This painless procedure helps determine the location and presence of a blockage within the tear drainage system.

Sometimes tearing is the result of the nasolacrimal duct or tear duct being partially or completely blocked. In cases where the symptoms are bothersome, a surgical procedure can be performed that creates a bypass away from the blocked tear duct. This procedure is called a dacryocystorhinostomy (DCR). A DCR is performed by creating a new passageway from the lacrimal sac to the nasal infrastructure, bypassing the obstruction.

There are two ways to create this opening: external and internal. The internal procedure is performed with an otolaryngologist and this process can be discussed during the evaluation.

Additional Information

The DCR surgery is performed as an outpatient procedure at Central DuPage Hospital. It requires general anesthesia. A DCR should be performed by a surgeon specializing in the care and treatment of the lacrimal system. As an ASOPRS oculoplastic surgeon, Dr. Pak has advanced training in the evaluation, care and treatment of the lacrimal system.

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