Lacrimal System Procedures
Dr. Liu has helped thousands of individuals achieve their cosmetic goals and discover renewed confidence.
When you experience tearing, it typically is either due to an overproduction of tears, tears not draining properly out of your eyes, or a combination of the two. Your eyes may overproduce tears if you have dry eyes, allergies, eye surface irritation, infection, or inflammation. We usually treat these conditions with over-the-counter medications, such as artificial tears, allergy drops, anti-inflammatory drops, or oral medication, although some patients require antibiotic drops.
If you aren’t experiencing the issues discussed above, your tears may not be draining out of your eyes correctly. We produce tears constantly throughout the day, but you don’t typically notice because tears drain into the lacrimal system. These issues are slightly more difficult to diagnose, but usually fall into one of several categories:
As shown in the diagram below, in a normally functioning lacrimal drainage system, the tears will leave the eye from the two small tear drains (puncta) then travel through two small tear tubes (canaliculi) before emptying into the tear sac (lacrimal sac) and then ultimately passing through the duct (nasolacrimal duct) into the nose.
Depending on where the blockage of the drainage pathway is located, some of the most common options for treatment include:
During your initial office visit, Dr. Liu will determine where the blockage is located in the lacrimal drainage pathway. She may perform a diagnostic test called lacrimal probing and irrigation where a saline solution is flushed through the lacrimal drainage pathway to see if there is a blockage. If there is no blockage then no further procedure is typically needed. If there is a blockage, an additional procedure may need to be performed either in our office or scheduled at an outpatient surgery center.
Certain types of lacrimal system surgery such as punctoplasty or lacrimal stent placement can be performed using local anesthesia in Dr. Liu’s procedure room or under IV (intravenous) sedation at an off-site surgery center. For your comfort, DCR and CDCR surgeries are typically performed under general anesthesia at an outpatient surgery center where you can go home the same day.
Depending on the location of the tear drainage blockage, Dr. Liu will select the specific techniques that are suited for your needs.DCR and CDCR surgeries can be performed using an endoscopic approach with a camera inside the nose or an external approach by cutting through the skin between the eye and nose, Dr. Liu prefers to perform the surgeries endoscopically if possible to avoid leaving a scar on the face. With several of these lacrimal system procedures, a fine clear silicone tube is placed through the lacrimal drainage pathway to keep it open for 1 to 6 months.
Office procedures such as the punctoplasty or probing with stent placement can usually be performed in less than a half hour. DCR and CDCR surgeries typically take about 1-2 hours from start to finish.
Since Dr. Liu prefers to perform lacrimal surgeries minimally invasively or endoscopically, there is no visible scarring on the skin.
Please refer to the resources here for detailed pre- and post-operative instructions.
Written on August 24, 2019
Dr. Liu is a master micro-surgeon. It’s been two months since my operation and no one has suspected I had plastic surgery. I look ten years younger, my husband is thrilled and so am I. A dear friend of mine jut told me I look just as beautiful as I did when we first met over 40 years ago. I couldn’t be happier with the results and worth every penny and the few weeks of discomfort. So glad I chose Dr. Liu.
As a valued member of our patient community, we appreciate the trust you place in us and want to inform you about how we are addressing the coronavirus (COVID-19) situation. We are closely monitoring events in our local community and continuously updating our policies and protocols as a result of new information; it is our priority to keep our patients, staff, and community safe. Our office has taken several steps to ensure that you receive the same high-quality care that you have come to expect by increasing our safety measures:
Prior to an office visit, all patients will be screened over the phone for COVID-19 symptoms and travel history to determine how our office can provide the best care. Your honesty in answering these questions is greatly appreciated by all patients and staff. All office visits are by appointment only at this time, we will not be accepting walk-ins.
Upon arrival at our office, everyone will receive a temperature check. If the reading shows an elevated temperature, we will ask you to contact your primary care physician and reschedule your appointment.
Our waiting room has been rearranged to allow wide-spaced seating to support safe physical distancing. Patient scheduling is structured to have as few patients in the office at one time as possible.
In all areas of the office, our staff follows sanitation guidelines as recommended by the Centers for Disease Control and Prevention (CDC).
Please be assured that we are taking all possible steps to ensure the safety of our patients and our staff, and your help is instrumental in achieving this goal. If you do not feel comfortable coming into the office, we also offer virtual consultations. Even in these challenging and unprecedented times, know that we are always here to care for you.
Please call 949-200-6838 to schedule your in-person or virtual consultation.