Acquired nasolacrimal duct obstruction (NLO) causes symptoms of epiphora which can be associated with stickiness, dacryocystitis and interference with tear film causing visual blurring . The annual incidence rate of NLO is 20 per 100,000, with the majority of patients being females above the age of 66 years . While the aetiology is usually unknown, the site of obstruction is more commonly distal and invariably amenable to treatment by DCR surgery [3-4]. Proximal NLO at the level of the cancaliculi is less common but may still be treatable by extended DCR techniques including canalulostomy. In patients with upper system atresia, or who have acquired obstruction unresponsive to DCR techniques, a conjunctival DCR (CDCR) may be the only other option. This article is protected by copyright. All rights reserved.
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