Nasal endoscopic examination is an important part of the preoperative assessment in patients presenting with nasolacrimal duct obstruction, particularly when planning endoscopic dacryocystorhinostomy (DCR). Deviated nasal septum can impede the access to the middle meatus and identifying this preoperatively facilitates surgical planning for simultaneous septoplasty where indicated. Other pathologies such as synechia, nasal polyps and chronic rhino-sinusitis can also be identified during the nasal endoscopic examination preoperatively.

We routinely use a flexible endoscope for nasal examination in the clinic for preoperative assessment. A flexible endoscope is easier to use than a rigid endoscope [1] and is well tolerated without the need of topical nasal anaesthesia or decongestant. However, only one clinician can view through the eyepiece of the endoscope at any one time and it is not possible to demonstrate or teach simultaneously.

Using a smartphone adaptor enables live image display on the screen of the smartphone, which can be viewed by more than one clinician at a time [2].

It also allows the use of a flexible endoscope for removing silicone stents postoperatively, as the surgeon can use one hand to hold the forceps and the other to hold the tip of the flexible endoscope (Fig. 1). There is no need to hold the eyepiece of the endoscope, as this is attached to the smartphone and is held by an assistant (Fig. 1).

Fig. 1
figure 1

Smartphone adaptor for nasal endoscopy set up

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The smartphone adaptor (RVA Smart-Clamp) shown in figure 2 costs less than £115.00 and fits most of the modern smartphones (Fig. 2). This adaptor can be used with a flexible or rigid endoscope with a 31.75 mm eyepiece. There are several varieties of smartphone adaptors available in the market and we do not have any financial interest in any of the adaptors. Smartphone adaptor is significantly cheaper and a less cumbersome alternative than a camera with monitor attachment required for displaying the image.

Fig. 2
figure 2

Smartphone adaptor with the flexible nasal endoscope

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We use a smartphone adaptor for preoperative and postoperative examination in patients undergoing DCR (see Supplementary video) and find it very useful in training junior doctors/fellows in the oculoplastic clinic. Attaching the smartphone adaptor to the flexible endoscope frees a hand of the clinician to allow removal of silicone stents postoperatively (see Supplementary video). We find this particularly useful, as flexible endoscope is more comfortable for patients compared to a rigid endoscope and can be used without the need of topical nasal anaesthesia or decongestant.