Frequently Asked Questions:
Blocked Tear Duct and Silicone Intubation
What is nasolacrimal duct obstruction?
Tears normally drain away from the eye through small holes on the eyelid
called puncta, then through the tear duct which opens into the nose. If the
passageway is narrow (stenosed) or blocked, excessive tearing may result.
Irrigation of the drainage system is performed in office to determine whether
the tear duct is blocked.
What are treatments for nasolacrimal duct obstruction?
The main treatments for blocked tear duct include stenting with silicone tube
(usually for partial blockage) and dacryocystorhinostomy (DCR, usually for
more severe blockage).
What is silicone intubation?
A very thin silicone tube is passed through the openings of the tear drain in
the upper and lower eyelids, passed down the tear duct, and secured with a
suture to the inside of the nostril (see Photo 1). The silicone tube is kept in
place after the procedure to help open the drainage pathway. The procedure
is performed in an operating room under sedation or anesthesia and usually
takes less than 1 hour.
How long does the silicone tube
stay in after the surgery?
The silicone tube will usually stay
in place for 3-6 months and
sometimes up to 9 months,
depending on the degree and
location of blockage. The tube will
then be removed in office.
Diagram of silicone intubation of the left eye
Silicone tube is tied to the inside
the nostril with a suture
The only visible part of the
silicone tube is at the corner
of the eye
Tear flows across the eye
What should I do after the silicone intubation procedure?
You should use antibiotics/steroids drops and sometimes ointment as
instructed by your doctor, usually tapered over 3 weeks after the procedure.
You may experience some bloody discharge from your nose for a few days
after the surgery. Please avoid rubbing the inner corner of your eye,
forceful nose blowing, nose picking or poking at the tube. This could
cause the silicone tube to come out sooner than planned, and limit the
effectiveness of the procedure.
What should I do if my nose is congested after the silicone intubation?
You can use over-the-counter nasal saline (for example ENTSOL® or
Ocean® Spray) as needed to relieve the nasal congestion. Afrin® may be
used as well, but no longer than 3 days to prevent unwanted side effects.
What does it look like to have a silicone tube in place?
You may notice a clear plastic tube connecting at the inner corner of your
eye. It is barely noticeable for most people (see Photo 2).
Why am I still tearing after I
had a silicone intubation
Most patients will notice a
significant improvement in tearing
shortly after silicone intubation.
However, a subset of patients will
have continued watering until the
tube is removed. For a small group
of patients (approximately 10%),
the tearing is actually worse when
the tubing is in place. Most, but
not all, patients eventually notice
improvement in the excess tearing
by the time the tubing has been
Photo 2: Photograph of the right eye 1 week
after silicone intubation. Please note the clear
silicone tube at the inside corner of the right
If the silicone tube comes out, what should I do?
Generally the tube will stay in place without problems. If the tube becomes
dislodged, you may notice a loop of silicone tube coming out from the
corner of your eye. You should tape the loop to your nose and call the
doctor’s office as soon as possible. Do not pull it out or cut it.
Thank you for placing your trust in our team at UW Health. If you have
additional questions, please let us know or call our office at 608-263-7171.
Mark J. Lucarelli, MD, FACS
Oculoplastic, Facial Cosmetic and
Cat Burkat, MD, FACS
Oculoplastic, Facial Cosmetic, and
Your health care team may have given you this information as part of your care. If so, please use it and call
if you have any questions. If this information was not given to you as part of your care, please check with
your doctor. This is not medical advice. This is not to be used for diagnosis or treatment of any medical
condition. Because each person’s health needs are different, you should talk with your doctor or others on
your health care team when using this information. If you have an emergency, please call 911. Copyright ©
1/2016 University of Wisconsin Hospital and Clinics Authority. All rights reserved. Produced by the
Department of Nursing. HF#7514
Tape the loop of silicone tube to
your nose if it comes out.
Do not cut it or pull it out.