IntroductionN ormal drainage of tear from the conjunctival sac into the nose is dependent on patency of the naso lacrimal passage that includes the lacrimal puncta, the lacrimal canaliculi, the common canaliculus, the lacrimal sac and the nasolacrimal duct, which opens into the inferior meatus of the nose. Blockage of any portion this passage, from puncti down to the nasolacrimal duct, by inflammation and scarring, trauma, stone or neoplasm results in epiphora. In cases of obstruction of the nasolacrimal duct dacryocystorhinostomy (DCR) has been the standard surgical recourse. This operation is designed to drain the tears and the infected secretion from lacrimal sac into the middle meatus of the nose through an ostium in the lacrimal bone and the nasal mucosa. Toti originally described dacryocystorhinostomy (DCR) in 1904 [1]. Since then DCR surgery through an external approach has been the gold standard for the treatment of nasolacrimal duct obstruction with a success rate of over 90% [2]. Endoscopic dacryocystorhinostomy (endoscopic DCR), performed through an intranasal route was first described by McDonogh in 1989 [3]. Since then various workers [4,5] have published their experiences with endoscopic DCR from time to time. We share our experience with external and the endoscopic DCR in a retrospective study. Material and MethodsA retrospective study was conducted on a total of 103 cases of nasolacrimal duct obstruction treated by us. A total of 51 cases (55 sacs) treated by external DCR and 52 cases (54 sacs) treated by endoscopic DCR were included. Patients having epiphora due to chronic nasolacrimal duct obstruction resulting from chronic dacryocystitis with or without mucocoele were included in the study.Cases of canalicular or common canalicular obstruction, lid laxity, previous lacrimal surgery, cases with suspicion of malignancy, previous radiation therapy, posttraumatic lids / bony deformity were excluded from the study. A record of complete ophthalmic and rhinological examination was considered.External DCR: All surgeries were performed under local anaesthesia by infiltration of the area around the lacrimal sac with 2% xylocaine with adrenaline 1 in 100,000. Nasal packing was done with gauze socked in 4% xylocaine and 1 in 100,000 adrenaline. In all the cases both the anterior and posterior lacrimal sac flaps were sutured with the nasal mucosa. The External Versus Endoscopic

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Conjunctival-limbal autograft is the procedure of choice for primary and recurrent pterygia.

A total of 24% cases showed abnormal (<5 seconds) TBUT. Abnormality of tear film in the presence of low humidity and windy condition with high ultraviolet radiation may lead to ocular discomfort and pterygium in these areas.

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