A Comprehensive Review of Dacryoscintigraphy: Part I—Indications, Techniques, and Utility

Purpose: To evaluate the diagnostic accuracy of dacryoscintigraphy (DSG) in patients with epiphora and its relevance in everyday medical practice. Methods: The authors performed a PubMed/Medline search of all articles published in English and other languages on DSG. The data analyzed included the techniques and indications of DSG, the interpretation of the results, and the clinical utility and limitations of DSG. Results: The present major review suggests that the findings of DSG do not add significantly to a thorough clinical examination. The diagnostic reliability of DSG is limited by the lack of standardization, poor anatomical resolution, poor quality of images, intra- and interobserver variability, low specificity, insufficient correlation with clinical findings, the inability to distinguish stenosis from obstructions, and the inability to assess the results of lacrimal surgery. These limitations raise concerns regarding any justification for its use in everyday lacrimal practice. Conclusion: DSG is not routinely used by the vast majority of lacrimal surgeons worldwide given that in most cases, it does not profoundly impact clinical decision-making.