DCR Post Operative Advice (Dacryocystorhinostomy)

What to expect on the day of your surgery:

• If bleeding occurs at the end of surgery, the surgeon may pack the nostril, some of the nose packs will be removed before you leave the ward but some are left in the nose but will dissolve itself.
• Discomfort and spots of blood around the nostril.
• Trickling of blood from the nose can occur when you begin to move.
• For external DCRs there will be a small wound on the outside of the nasal bridge with stitches and bruising present. (Stitches will be removed 2 weeks later in clinic).
• Increased watering of the eye (blood staining is normal).
• Your wound may ache, take simple over the counter painkillers if needed.
• Sleep upright with 2 or more pillows for the first 24hrs.
• You may experience nasal discharge or congestion (this may last 2-3 weeks).

The morning after your operation:

• Gently remove the dressing from your nasal bridge (if still in place).
• Wash your hands.
• With sterile cotton wool, clean your eye with cool boiled water. Wipe from the nose outwards.
• Instil your eye drops/nasal spray as prescribed.
• With external DCR, topical antibiotic cream will need to be applied to the nasal wound for up to a week, 3-4 times a day.

You are advised:

• Do not vigorously blow or pick your nose following surgery as it may dislodge the tube that keeps the tear canal open, as well as cause bleeding. Gently dab with a clean disposable tissue.
• Do not drink tea or coffee for 2 days.
• Do not eat hot food or drink hot beverages for 48 hours.
• Sneeze through your mouth pinching your nose.
• You must keep the nasal bridge wound clean and dry until the stitches have been removed.
• Do not rub your eyes.
• Avoid strenuous activities/lifting for 7 – 10 days, to prevent bleeding.
• Avoid smoking as this irritates the inside of the nose and could cause bleeding.
• Do not drive for 2 days after your operation.
• Aim to take at least 1 week off work.
• Do not wear eye make up for 2 weeks.
• Do not perm/ colour your hair for 2 weeks.
• Do not go swimming for 2 – 3 weeks.

You can:

• Wash your hair, but with head backwards.
• Shower/bathe as normal, avoid getting soap/shampoo in the eye.
• Do light housework and shopping.
• Read, watch TV.
• Restart your warfarin/aspirin 24 hours after surgery.

Going forward:

2-3 months after surgery the tubes will be removed in clinic. The tubes are snipped from the outside then you blow your nose to extract them. If the tubes remain in the nose a small camera is passed up the nostril to locate the tube. Your tear ducts will be syringed to ensure they are patent.

Contact us if:

• Your vision deteriorates.
• If you experience severe pain, not relieved by painkillers.
• If you develop a sticky green/yellow discharge.
• If you experience new floaters.
• If you injure your eye.
• Your tube comes out from your tear duct.
• If you experience a severe nose bleed and significant blurred vision go immediately to your local casualty department.

Contacts: