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Dacrocystography
1.
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
4.
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
6.
7.
8.
9. Epiphoria
Fistula
Tumors
Diverticula
Dacrolith
Lacrimal duct obstruction
Chronic dacrocystitis
Before any intervention to
nasolacrimal tract
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
18.
19. Macro Dacro Cystography (0.3 mm focal spot for enlarging the
image)
Digital substraction dacrocystography
CT dacrocystography