The Valsalva DCR bubble test: a new method of assessing lacrimal patency after DCR surgery

Objective confirmation of nasolacrimal patency following dacryocystorhinostomy is a desirable postoperative goal for both the surgeon and the patient. The authors describe a simple method to demonstrate dacryocystorhinostomy patency and present a study comparing the effectiveness of this novel test with Jones fluorescein testing in 32 cases seen consecutively at postoperative follow-up. The test consists of demonstrating reflux of air through the dacryocystorhinostomy as the patient performs the Valsalva maneuver. This reflux is most easily seen as bubbles rising through a drop of saline placed in the medial canthus. A high correlation was found between this test and Jones testing. The Valsalva dacryocystorhinostomy bubble test (VBT) appears to be a fast, safe, and accurate method of confirming dacryocystorhinostomy patency.