Dacryocystorhinostomy

True epiphora refers to excessive watering of the eye due to the obstruction of lacrimal passages. It can be due to primary “idiopathic” or secondary to inflammatory, traumatic, or neoplastic causes. It can be divided into four clinical grades according to the amount and type of the fluid. Main diagnostic tests include diagnostic probing, Schirmer’s test, fluorescein dye disappearance test, syringing, dacryocystography, computed tomography, and magnetic resonance imaging. Conservative treatment of nasolacrimal duct obstruction may include measures to reestablish the natural flow such as topical or oral antibiotics and anti-inflammatory medications along with office-based canalicular probing and lacrimal irrigation. There are two approaches for dacryocystorhinostomy: external and endoscopic endonasal approaches. The endoscopic approach has gained more acceptance nowadays due to many reasons. These include the absence of an external scar, less periorbital ecchymosis, and less incidence of injury to the medial canthal tendon.