A constantly watery eye (epiphora) is often caused by a blocked tear duct. Tears that should drain from the eye into the nose back up instead, overflowing onto the cheek and leaving the eye wet, sticky and prone to infection of the tear sac. A dacryocystorhinostomy (DCR) cures this by creating a new opening between the tear sac and the nasal cavity, bypassing the blockage. The endoscopic approach does it entirely through the nostril – no skin incision, no facial scar – and resolves or substantially improves the watering in around 80–92% of patients.
What endoscopic DCR treats
The tear duct runs from the inner corner of the eye down into the nose. When it becomes obstructed – through age-related narrowing, chronic inflammation, stones or previous infection (dacryocystitis) – tears cannot drain, and the eye waters all the time. DCR restores drainage by opening a direct channel from the tear sac into the nose.
Not every watery eye needs DCR, though. A careful consultation first rules out treatable non-obstructive causes such as dry-eye reflex watering, blepharitis, lid laxity or malposition (ectropion or entropion), and punctal problems – many of which are corrected without major surgery. DCR is reserved for a genuine anatomical blockage confirmed on syringing and tear-drainage testing.
DCR approaches
The blockage can be bypassed in more than one way. The endoscopic, no-scar approach is the modern first choice for most patients; external DCR and revision surgery have specific roles.
Watery eye driving you mad? One consultation confirms whether your tear duct is blocked and whether a no-scar DCR will fix it.
Book your assessmentHow endoscopic DCR is done
Endoscopic DCR is usually performed under general anaesthetic as a day case, which gives the surgeon a still, controlled field. Using fine rigid endoscopes passed through the nostril, the surgeon makes a small opening in the bone over the tear sac and opens the sac into the nasal cavity, creating a new drainage channel – with no incision on the face.
Soft silicone tubes are then passed through the tear ducts and tied discreetly inside the nose to hold the new channel open while it heals. The operation takes about 45–90 minutes per side; total time in hospital is usually four to six hours. You go home the same day with nasal saline and a short course of drops and spray.
Recovery and aftercare
First 24–48 hours
Expect mild nasal congestion, a little nasal bleeding and a metallic taste from swallowed blood – all settle quickly. Discomfort is usually mild and controlled with simple painkillers. There is no facial scar.
First week
Use antibiotic drops and start saline nasal rinses. Most patients return to desk work in 3–5 days. Driving is fine once the anaesthetic has fully worn off and you feel alert.
2–3 weeks
Avoid nose-blowing, vigorous exercise and air travel while the channel heals. A steroid nasal spray reduces granulation. The watering usually improves steadily as the new opening matures.
8–12 weeks
The silicone tubes are removed in clinic under anaesthetic drops – a brief, painless, stitch-free procedure – and the new opening is checked. Most patients have a dry, comfortable eye from this point.
Endoscopic DCR cost in the UK (2026)
Private self-pay endoscopic DCR in the UK in 2026 is typically £4,200–6,500 per side, all-inclusive of the consultant oculoplastic assessment, tear-drainage tests, the day-case operation with nasal endoscopes, silicone tube intubation for 8–12 weeks, the post-operative reviews and tube removal. Bilateral simultaneous endoscopic DCR is £7,800–11,500 – significantly less than two separate operations.
Most major UK insurers (Bupa, AXA Health, Aviva, Vitality, WPA) cover endoscopic DCR for documented tear-duct obstruction or chronic tear-sac infection, subject to pre-authorisation; we prepare the clinical pack on your behalf. See our oculoplastic price guide or the full price list.
Endoscopic DCR FAQs
How much does private endoscopic DCR cost in the UK in 2026?
Private self-pay endoscopic DCR (dacryocystorhinostomy) for a watery eye from blocked tear drainage is typically £4,200–6,500 per side in the UK in 2026, all-inclusive of the consultant oculoplastic assessment, tear-drainage tests, the day-case general-anaesthetic operation with nasal endoscopes, silicone tube intubation for 8–12 weeks, the post-operative reviews and tube removal. Bilateral simultaneous endoscopic DCR is £7,800–11,500, which is significantly less than two separate operations.
What is endoscopic DCR and how is it different from external DCR?
A DCR creates a new drainage channel between the tear sac and the nose, bypassing a blocked tear duct. Endoscopic DCR is performed entirely through the nostril with fine nasal endoscopes – there is no skin incision and no facial scar, recovery is quicker, and any nasal problems can be treated at the same time. External DCR uses a small skin incision beside the nose and is still preferred by some surgeons for revision or post-traumatic cases. Anatomical success is comparable (about 85–95%), with better cosmesis from the endoscopic approach.
Is endoscopic DCR done under general or local anaesthetic?
Endoscopic DCR is most commonly performed under general anaesthetic as a day case, which gives a still, controlled surgical field. Local anaesthetic with sedation is feasible in carefully selected patients when general anaesthetic is best avoided. The operation takes about 45–90 minutes per side, and total time in hospital is usually four to six hours including pre-operative checks, recovery and discharge.
What is the success rate of endoscopic DCR?
In modern UK and international series, endoscopic DCR has an anatomical success rate of about 85–95% at the first operation, with functional success – the patient’s watery eye resolved or substantially improved – of around 80–92%. Audit data show comparable results for endoscopic and external DCR in primary cases. Revision DCR has a success rate of 60–85% and benefits from a brief application of mitomycin C to the new opening.
What is the recovery like after endoscopic DCR?
Discomfort is usually mild and controlled with simple painkillers, and there is no facial scar because the whole procedure is done through the nose. Expect mild nasal congestion, a little nasal bleeding for 24–48 hours and a metallic taste, all of which settle quickly. You use antibiotic drops, saline rinses and a steroid nasal spray for a few weeks, and most people return to desk work in 3–5 days; nose-blowing, vigorous exercise and air travel are avoided for 2–3 weeks. The silicone tubes are removed at 8–12 weeks.
How long do the silicone tubes stay in after endoscopic DCR?
Soft silicone tubes are usually left in place for 8–12 weeks to keep the new tear channel open while it heals and to prevent it narrowing. They sit discreetly through the tear ducts and are tied in the nose, and they do not affect your vision or driving. They are removed at your follow-up review in clinic under anaesthetic drops – a brief, painless, stitch-free procedure.