Dacrocystography is an imaging procedure used to evaluate the lacrimal drainage system. Contrast media is injected through the puncta into the lacrimal drainage structures and X-rays are taken to identify any obstructions or abnormalities. The lacrimal drainage system includes the lacrimal gland, conjunctival sac, puncta, canaliculi, lacrimal sac, and nasolacrimal duct. Dacrocystography can be used to investigate various conditions affecting tear production and drainage such as epiphora, fistulas, tumors, diverticula, obstructions, and infections.

2. :- Dacrocystography is a radiological
procedure by which nasolacrimal duct
system is opacified by injecting contrast
media into it.

3.  Tears (lacrimal fluid) are produced by the
lacrimal gland which is located at the
supero-lateral aspect of the orbit
 Drainage of the lacrimal fluid is achieved
by the lacrimal canaliculi , lacrimal sac and
nasolacrimal duct
 The lacrimal fluid drains from the
nasolacrimal duct into the nasal cavity via
the inferior meatus

5. :- It is concerned with the tear formation and transport
Lacrimal passage include:
 Lacrimal gland
 conjunctival sac
 Lacrimal puncta
 Lacrimal canaliculi
 Lacrimal sac
 Nasolacrimal duct

9.  Epiphoria
 Fistula
 Tumors
 Diverticula
 Dacrolith
 Lacrimal duct obstruction
 Chronic dacrocystitis
 Before any intervention to
nasolacrimal tract

10.  Contrast media allergy
 Pregnancy

11.  Lipiodol (Better
opacification but more
chances og granuloma
formation)
 Ionic /Non –ionic contrast
media
Lacrimal canula
Polyethylene catheter

12. Lignocaine Lipidol contrast
media
Punctum dilator
20 cc syringe

13. Lacrimal canula
18G blunt needle with polyethylene
catheter
20 cc syringe
Cotton tipped applicator
punctum dialator (Nettleship dilator)
Local anaesthetic drops –Lignocaine
4%

14.  Take patient history
 Completed consent form
 No diet restrictions
 Explain the procedure
 Advice to remove his metallic object

15. The patient lies supine on the fluoroscopy table
with their head in a reverse occipito-mental
position
Support either side of the patient’s head by
immobilization device, particularly if a substraction
technique is employed
Select a small field of view and fine focus
control image taken
Anaesthetic eye drop are used for patient
comfort
A fine cannula is inserted into the puncta of each
eye , then the eye is closed and the catheter taped

16. .
 It may necessary to dilate the puncta to facilitate
insertion of the cannula
 After the mask is required ,commence injection
 Images are taken immediately after injection
 A drainage image can be taken after 15 minutes if
considered necessary

17.  Anteroposterior
 Lateral
 Oblique views
 5- 30 min late films
Normal dacrocystogram show complete filling of
superior and inferior punctal ampullae, ascending and
descending canaliculi, common duct , lacrimal sac and
nasolacrimal duct

19.  Macro Dacro Cystography (0.3 mm focal spot for enlarging the
image)
 Digital substraction dacrocystography
 CT dacrocystography

20.  Contrast extravasation
 Granuloma formation (with lipidol)
 Injury to canaliculus (perforation)
 Infection