CTDCG assesses the anatomy of the lacrimal drainage system. The aim of this study IS to assess the value of CTDCG with lacrimal syringing for patients undergoing Endonasal Dacryocystorhinostomy(DCR).

Retrospective study of patients presenting to an Ophthalmology unit in North Wales with epiphora during 2003 to 2013. 82 patients with lacrimal duct obstruction were referred to ENT for CTDCG and DCR. Proximal obstruction = no passage of contrast past the lacrimal sac on CTDCG. Distal obstruction = contrast filling the lacrimal sac but did not enter the nose on CTDCG. Patent if saline passed to throat or contrast in nose on CTDCG.

Radiology reports, Ophthalmology and ENT notes were obtained for 28 eyes of 21 patients. Mean age 65.95 years (range 47-89), 24%male. Presenting with symptoms of epiphora for mean 38months,29% bilaterally. 10% had a change in symptoms when seeing ENT. Mean time between Ophthalmology review and DCR was 12.4months. 19% required additional surgery including septoplasty or sinus surgery. 5(24%) had sinus disease on DCG. DCG agreed with 72% of 25 eyes with a SWO obstruction. 3 further found on DCG of which 2 were operated on. DCG agreed with laterality of symptoms in 71%. Agreement between DCR side and obstruction on: SWO was 64%; 71% with DCG and 90% with presenting symptoms.
2(10%) suspicious lesions biopsied returned as no malignancy. Mean follow up 31.5months from Ophthalmology review to final follow up, 19% required revision. 10(48%) patients observed an improvement in symptoms at final follow up.

CTDCG identified 2 further obstructions compared to SWO that underwent DCR. Greatest agreement between which eye is finally operated on is with presenting symptoms.