Indications of endoscopic DCR :
- Epiphora associated c 10 acquired Naso Lacrimal Duct (NLD) obstruction
- Infection of Lacrimal sac associated c 10 acquired NLD obstruction.
- NLD obstruction 20 to specific inflammatory infiltrative disorder.
- The level of obstruction that is distal to the junction of the lacrimal sac and the duct.
- In the management of lacrimal duct injuries associated sinus surgery.
Contraindication of endoscopic DCR :
- Presence of a firm indurated mass above the level of medial canthus
- Bloody epiphora
- Presence of bony destruction as seen in radiological film.
- Pseudoepiphora(It is essentially reflux tearing in which the main gland over compensate secretion because of lack secretion from minor glands of along the lid margin).
Remarkable History of DCR
External dacryocystorhinostomy: Toti
1st dacryocystorhinstomy: Celus
Endonasal approach: 1st described: caldwell, west and Mosher
1st performed: Mc Donogh
Anterior lacrimal crest: Frontal process of maxillary
Posterior lacrimal crest: Lacrimal bone
Jones test:
- It is a test of the patency of the nasolacrimal system.
- Fluorescein is placed in the conjunctival sac and visualized in the nose after a period of 5 minute, there is impaired outflow →proximal obstruction , dye seen→distal obstruction.
