No Visible Scar with LASER Treatment

Endonasal Dacryocystorhinostomy or L-DCR.

The tear ducts are small holes in the nasal corner of each eyelid, upper and lower, that drain tears and mucous from the eyes into the nasal sinus. Dr. Affleck is the first ophthalmologist in Eastern Idaho to use laser technology to unblock tear ducts obstructed by bone.  This treatment is know as Endonasal Dacryocystorhinostomy (L-DCR).

If you suffer from excessive tearing, redness of the white part of your eye, or have painful swelling near the inside corner of your eye, make an appointment with us today!

In This Article

     Commonly Misdiagnosed
     Treatment is Surgery
    Common Signs and Symptoms
     Second Surgeon
     What is the difference between external and Endonasal


Since the symptoms of a tear duct obstruction and other conditions, such as dry eyes and allergies overlap a blocked tear duct can be misdiagnosed.

Dr. Affleck uses a simple technique in the office to assure the correct diagnosis.  Often, this involves gently flushing a small amount of water into the duct to see if any makes it into the nose.


In adults, the tight bony canal often fills in with new bone, so the approach to restore flow is different than children.  In most cases of obstruction in adults, the definitive treatment is surgery.


Blocked tear duct at any age can decrease your vision and cause pain. Tears duct when working properly keep you and your eyes healthy and happy.


Signs and

This list is not inclusive

  • Non-clear (mucus) eye discharge
  • Excessive tearing
  • Repeated eye infections
  • Repeated eye swolling
  • Crusting around eyelids
  • Eye redness
  • Blurred vision
  • Pain near the eye's inside corner
Dr. Affleck treats blocked tear ducts of all ages


In adults, an obstruction in the ducts can be caused by trauma, like a broken nose, surgery in the nasal sinus, chronic sinus inflammation, or sometimes without cause.  The bottom end of the tear duct is a small bony canal, and often after an obstruction develops, the bone closes off the canal.

The surgery involves making a small opening in the bone in the sinus to effectively make a bypass tract for tears to drain. Dr Affleck starts by using an endoscopic approach that employs a laser to make the opening in the bone.  This requires much less manipulation of the tissue, has less pain post operatively, and in many studies, has a higher success rate with less scarring.



This technique involves a second surgeon. An ear, nose and throat surgeon uses a nasal endoscopy.  The surgeon identifies the best location for the opening, and the laser is used to make the opening.


All adult tear duct surgeries are done under general anesthesia.  During these surgeries, a tube is placed into the ducts, and through the new opening in the bone.  The tube prevents the new opening from scarring closed.  The tube is left in place for 6-8 weeks, or longer, and then removed in the office.


Ask Aaron J. Affleck, M.D.

It all starts with an exam with Dr. Affleck. Call us at at 208-523-6868! 

You pronounce it dak-ree-o-sis-toe-ry-nost-o-mee.  However, around the office we call it a DCR.

Normally, the bone will not grow back.  However, there is a small percentage of patients that the bone grows back and the treatments will need to be repeated.

  • Infants and Senior
  • Females
  • History of frequent eye infections
  • Previous eye, eyelid or nasal surgery
  • Glaucoma patients
  • Pervious cancer treatment


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