Lacrimal Gland Injections

Functional oculoplastic surgery focuses on the eyelids, eye sockets and facial structures around the eye area. It’s a highly specialised surgical procedure combining ophthalmology and plastic surgery. The surgeries are also delicate and involve operating on incredibly fine structures.


Watery eyes are a common condition that typically resolves without intervention. The eyes continuously generate lubricating tears; normally, these drain through the tear drainage system into the nose via the nasolacrimal duct. Various factors can disrupt this drainage process, causing excessive tearing.

Persistent tearing, known as epiphora, can result in symptoms such as blurred vision, sticky eyes, discomfort, irritated eyelids, and itching. It may also contribute to a runny nose. If home remedies or addressing underlying causes like blepharitis or dry eyes prove ineffective in resolving watery eyes, treatment may be required.

In some patients, excessive tearing is due to abnormal nerve connections and typically occurs when chewing or eating. Muscle relaxing injections into the lacrimal gland temporarily reduces this excessive production of tears without damaging the gland.

For patients who have already undergone nasolacrimal duct obstruction surgery but are still experiencing tearing, Lacrimal Gland Injections can give further relief by decreasing tear production.


You will be given local anaesthetic drops to numb the eye, which will reduce any discomfort felt during the procedure. Dr Nick Koutroumanos will inject a small amount of the product into the lacrimal gland, also known as the tear gland. This will be done either through the upper lid or just underneath the lid by turning the lid over.

There are no incisions required, so downtime is minimal. You will be able to return home after your injection, and any discomfort is easily managed with over-the-counter painkillers. You may also develop a small bruise, which will resolve in a few days.

Side effects are rare and likely to be temporary. They include:

  • slight bruising of the eyelid.
  • dry eye: this may need to be treated with artificial tear drops
  • drooping of the eyelid
  • temporary double vision

You should expect noticeable results within a few days of your treatment, and they should last between three to five months before you can return for a repeat procedure.

Eyelid surgery expert

Oculoplastic surgeon London


Dr Nick Koutroumanos

Dr Nick Koutroumanos is a London-based Ophthalmic & Oculoplastic surgeon, with particular subspecialty expertise in ophthalmic plastic & reconstructive eyelid, orbital and lacrimal surgery.

His private practice, based at The Hospital of St John & St Elizabeth in St John’s Wood complements his work in charge of a large NHS oculoplastics practice at the Royal Free Hospital in Hampstead.

A qualified senior trainer and Royal College Examiner in ophthalmic plastic surgery, cataract surgery and general ophthalmology, he runs an Oculoplastics Fellowship training programme that is highly sought-after by both UK and international candidates.

Kind Words from Our Patients


A true perfectionist

Words are not enough to express my sincere gratitude for the care and dedication Dr Koutroumanos put into my journey. I felt safe and secure in his hands. This is someone who truly cares about outcome and ethics of practice. A true perfectionist. I would not hesitate to wholeheartedly recommend him.

100% worth it

I had surgery a few days ago with Dr Koutroumanos for congenital ptosis. It’s early days but I don’t think it’s too early to say the results will be life changing for me in terms of confidence levels. I struggled at school due to the condition and have learnt to live with it – that is until I saw the doctor who was reassuring from the start and has just done the best job. 100% worth it and amazing to know I was in such safe hands. I can’t thank him enough.

I’m really happy with my results

I’ve recently had a brow lift and blepharoplasty with Mr N Koutroumanos. The whole process from start to finish was handled professionally and each process was very informative. I’m still at the recovery stage, so far I’m really happy with my results. Highly recommend using Mr N Koutroumanos services.