Информации за тековно работење во услови на Ковид - 19


Tears have a positive role – they are a physiological protective mechanism that has multiple functions: they protect and purify the eyes, moisten the cornea and maintain the transparency of the eye so that we can see normally.

There is a dynamic in the production of tears throughout the day, but if there is no normal outflow of tears, they collect in the lacrimal sac and the tear duct is blocked.


The tear duct is part of the tear drainage system. It drains the tears through the nasal bone and into the back of the nose. The tear duct is also called the nasolacrimal duct. Tears are produced in the glands under the eyelids.

The primary function of the tears is to keep eyes moist and clean. They are then drained through the tear ducts. When the tear duct is blocked (blockade), tears cannot drain.

  • Symptoms

Symptoms of a blocked tear duct occur with:

  • Excessive tearing
  • Redness of the white part of the eye
  • Chronic eye infection or inflammation (pink eye)
  • Painful swelling near the inner corner of the eye
  • Crust on the eyelids
  • Mucus or purulent discharge from the lids and surface of the eye
  • Blurred vision


Blockage of the tear ducts is a common condition in newborns that improves during the first year of life, without the need for additional treatment. In adults, it can be the result of inflammation, injury, and rarely, a tumor.

This condition can almost always be corrected. Treatment depends on the cause of the blockage and the age of the affected person.


During the examination, a basic ophthalmological examination is performed, during which the tear duct is checked. The inside of the nose is also checked to determine if there are certain structural disorders of the nasal passages that may be causing the blockage of the tear ducts.

The examination is adapted depending on the age of the patient, i.e. whether he is a baby, a child or an adult.


If necessary, additional examinations such as tests for quantitative measurement of the amount of tears are also performed:

  • Schirmer test: which measures basal and reflex tear secretion.
  • TUBT (Tear break time test): which measures the speed of tear loss from the surface of the cornea.

Probe and irrigation – your ophthalmologist may drain a saline solution through the tear duct to check that it is clear. Or he may insert a thin instrument (probe) through the tiny drainage holes at the corner of your lid (puncta) to check if the duct is blocked. In some cases this test may even solve the problem.

Interventions are performed under general anesthesia in the operating room, except for incision and drainage, which is an outpatient procedure and is performed under local anesthesia.

Preoperative preparation

If the lacrimal sac is inflamed, it should be treated with systemic antibiotic therapy and local therapy before surgery.

An anesthesiology examination is performed, during which a complete anamnesis is taken about the patient’s condition, i.e. from the child’s parents.

Patients with chronic diseases, depending on the therapy they are receiving, have special preparations for which they are informed on the day of scheduling the intervention.

After the patient is fully prepared, he is brought into the operating room.

Course of surgery

The intervention that treats the tear duct is called a dacryocystorhinostomy.

With this intervention, an artificial opening is formed in the nasal bone and is connected to the tear ducts, which will allow tears to flow normally from the eye into the nasal cavity.

The steps in this procedure vary, depending on the location and extent of the blocked tear duct, as well as your surgeon’s experience and preferences.

Interventions are performed under general anesthesia in the operating room, except for irrigation and probing, which is an outpatient procedure and is performed under local anesthesia.

Postoperative care

The first follow up after the intervention is scheduled after a week, during which the bandage is removed and the eye is examined.

Then, in agreement with the surgeon, the following follow ups are scheduled. After the intervention, it is recommended to use a nasal decongestant spray and eye drops to prevent infection and reduce inflammation.

After six to 12 weeks, any stents used to keep the new canal open during the healing process will be removed.

In the event of symptoms such as excessive nosebleeds lasting more than an hour, seek your ophthalmologist immediately.


Restrictions after the intervention are temporary and do not last long and are always according to the surgeon’s recommendation.

Patients must not fly or swim for 2-3 weeks, avoid hot drinks for 36 hours and not blow their nose for 2 weeks. Strenuous exercise should also be avoided for at least ten days and they should sleep with their head elevated on an extra pillow.

Many patients continue to have watery eyes for several weeks after the procedure until the swelling and inflammation subside, and the nasal stent is removed. Although the skin incision heals within a few weeks, the internal swelling and healing may take several months to subside, so occasional tearing can be expected for several months after the procedure.


The package includes: intervention with local anesthesia, preoperative preparation and two follow-ups after intervention.

Anesthesiology examination and general anesthesia are charged additionally.

It is possible to pay in installments without interest and additional costs.

You can check more about the payment method on the current price list of Sistina Ophthalmology.

Ophthalmic examination

Refraction, visual acuity measurement, eye pressure measurement – examination of anterior segment.


Rinsing of tear ducts


 Irrigation and probing of tear ducts