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Causes of Tearing

The tear film on the surface of the eye is a critical component of maintaining vision. Tears nourish and lubricate the surface of the eye as well as wash away debris. If there is a disturbance of the tear film, patients will often experience tearing, burning, irritation and most importantly blurred vision. Patients who experience tearing, or epiphora, either have a problem with tear production or tear drainage, including dry eyes, blepharitis, eyelid malposition (ectropion, entropion, eyelid retraction), nasolacrimal duct(tear duct) obstruction (congenital and acquired).

Increased Tear Production and Dry Eyes

As odd as it sounds, the most common cause of tearing is dry eyes. If your eye doesn’t make enough tears, the lacrimal gland responds by secreting watery tears that don’t stick to the eye. So despite the tears spilling from your lids, the eye continues to be dry. The eye has two sets of structures that produce tears. Smaller tear glands help maintain a baseline level of moisture on the surface of the eye. Unfortunately, inflammatory conditions like rheumatoid arthritis, Sjogrens disease as well as aging and menopause lead to decreased tear production. As tear production diminishes, the surface of the eye starts to dry out.

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Combined DCR and Rhinoplasty with Septoplasty

Dr. Mehryar (Ray) Taban is the ONLY surgeon in the world who performs combined tear duct surgery (DCR) and cosmetic rhinoplasty (plus functional nose surgery, septoplasty, etc) at the same time (“Rhino-DCR” or R-DCR operation).

Patients with tearing secondary to blocked tear ducts often have concurrent difficulty with breathing secondary to deviated septum or other nasal problem. They often require concurrent nose surgery (septal deviation surgery, turbinate surgery, nasal collapse surgery) along with tear duct surgery (DCR). This is usually done by two different surgeons (oculoplastic surgeon and nose surgeon) at different times, requiring two separate surgeries with two postoperative recoveries. Moreover, many patients are unhappy about the appearance of their nose and for many years, they have thought about undergoing cosmetic rhinoplasty but haven’t done it due to cost, recovery period, or stigmata of having had a “nose job”.

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