Excessive Tearing 3 Months Post-op Eyelid Surgery, How Can I Make it Stop?

Question

3 months after surgery,I started experiencing excessive tearning in both eyes.My surgeon was an Opthamologist.I have been seeing another opthamoligist about this problem.He has flushed my tear ducts 2 times with saline, prescribed dexamethasone-pf drops, plus a slew of other drops. After flushing, my eyes are 90% for 1 or 2 days, then they start the excessive tearing/redness again. Could this surgery have caused this? It did not appear for 3 months post op. What can I do to make this stop?

Manish H. Shah, MD, FACS · Answer

Hello,

	I think that Dr. Steinsapir is correct.  A second opinion might be in order.  Excess tearing, or epiphora, is typical in the early stages after blepharoplasty.  If you have late onset epiphora, you may have trouble with how your lid is apposing to your globe vs. lacrimal drainage problems.  A fellowship-trained Oculoplastic Surgeon is a great resource to evaluate your problem.

	Good luck,

	Dr. Shah

Kenneth D. Steinsapir, MD · Answer

Tearing related to eyelid surgery is never caused by a drainage issue.  It is likely that if the tearing is related to inadequate drainage, it would be unrelated to your surgery.  This set of issues is not very difficult to evaluate.  My I suggest that you look for a second opinion from a fellowship trained oculoplastic surgeon or a cornea specialist.

Andrew Miller, MD · Answer

Usually, tearing after Eyelid surgery is something that occurs right away.  This is due to swelling after surgery, a change in the muscular activity of the eyelid, or if too much skin has been resected.  This usually resolves over the first month or two.  If the problem didn't occur for three months after surgery, it very well may be a separate problem that may have nothing to do with the surgery.  Follow up with an ophthalmologist for a full exam to see if anything else could be wrong.  In the meantime, continue with aggressive lubrication.

Gary Lelli, Jr., MD · Answer

The most common cause of tearing is reflexive -- excess tears made secondary to eye irritation or dryness. Assuming that your eyes are not excessively dry or irritated, and that they close well after your surgery, I would presume that this is a separate problem and may be more functionally related to your tear duct (particularly since the symptoms improve for a few days after irrigation). You may need to consider more permanent lacrimal work, and in many cases, with early tear duct obstruction, placement of lacrimal microtubes can help resolve your tearing (roughly 80% success rate). Check back with your ophthalmologist, and if he/she is not trained in lacrimal surgery, see an oculoplastic specialist.

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