Clinical utility of dacryoscintigraphy in the assessment of nasolacrimal duct obstruction

ABSTRACT

Epiphora, or pathological overflow of tear due to obstruction in the nasolacrimal drainage system, is a common problem encountered in ophthalmology. The ophthalmologist relies mainly on symptoms to guide further diagnosis and therapy. However, there appears to be a discrepancy between the degree of discomfort experienced by the patient and the severity of pathological finding. The purpose of this study was to determine the clinical utility of dacryoscintigraphy in the assessment of nasolacrimal duct (NLD) obstruction. We retrospectively reviewed the records of 27 patients who underwent dacryoscintigraphy between July-January 2007. Thirty-six eyes in these patients had epiphora. Three eyes (8%) showed partial obstruction. On the other hand, 33/36 eyes (92%) had complete obstruction in different areas of the NLD system. Patients with complete obstruction were treated by dacryocystorhinostomy and silicon tube insertion. Patients with partial nasolacrimal duct obstruction were treated medically. Dacryoscintigraphy is a simple, non-invasive, safe and non-traumatic procedure in assessing NLD obstruction. It demonstrates anatomical pathway of tear by physiological drainage. This can aid the surgeon in localizing the site of obstruction and guide him in choosing the appropriate treatment.