Dacryoendoscopy can be performed in an anterograde or a retrograde manner. In the anterograde, evaluation sequence starts at the puncta and subsequently the canaliculus, lacrimal sac, and the nasolacrimal ducts are studied. This is technically demanding and bumping into the mucosal walls is not uncommon especially for the beginners. In the retrograde technique, the punctum is dilated with a Nettleship’s punctum dilator (Fig. 9.4), the dacyroendoscope is gently passed into the horizontal canaliculus from the upper punctum on an outstretched eyelid (Fig. 9.5) and gently turned 90° just as in probing and descends down till the inferior meatus (Fig. 9.6). Now the scope is gently retracted back very slowly to study each part of the lacrimal drainage system. Gentle forward and backward movements are continued all through to help evaluate the system thoroughly. The retrograde technique is much easier in technical terms. It is important to know that illumination may need to vary in different parts of the lacrimal system. For example, the illumination needs to be more while examining the interiors of lacrimal sac as compared to the nasolacrimal duct or canaliculi.