PURPOSE: To evaluate the significance of the surgical scar of external dacryocystorhinostomy (DCR) as assessed by the patients. DESIGN: Cross-sectional questionnaire-based study. METHODS: Two hundred ninety-seven external DCRs were performed in 263 patients at the private practices of consultants who were attached to the Sydney Eye Hospital. Structured questionnaires were sent to patients, and the responses were evaluated. Patients were asked to assess the visibility of the scar and the significance of the scar to them on a scale of 1 (least) to 5 (greatest). RESULTS: The average age of patients was 67.9± 16 years, (72% female, 28% male). Ninety-six percent of the patients were caucasians of Australian/West European descent. Sixty-one of 296 scars (20.6% ) were felt to be visible by patients; 31 scars (10.5% ) were rated > 1 on a scale of 1 to 5 and 12 scars (4% ) were rated > 2. The average age of patients was highest for those patients with invisible scars, and the lowest average age was for those with scars that were rated > 1. A significantly higher proportion of female patients complained of marked scarring ( >1 on a scale of 1 to 5). A significantly higher proportion of patients who complained of discomfort during suture removal also complained of marked scarring. CONCLUSION: In view of the low percentage of patients who complained of marked scarring, scarring should not be the main ground for deciding the approach to DCR surgery, particularly in older patients. These results are valid for the population that was studied and may be different for different racial backgrounds. PURPOSE: To evaluate the significance of the surgical scar of external dacryocystorhinostomy (DCR) as assessed by the patients. DESIGN: Two hundred ninety-seven external DCRs were performed in 263 patients at the private practices of consultants who were attached to the Sydney Eye Hospital. Structured questionnaires were sent to patients, and the responses were evaluated. Patients were asked to assess the visibility of the scar and the significance of the scar to them on a scale of 1 (least) Sixty-one of the patients were caucasians of Australian / West European descent. Sixty-one of 296 (67% ± 16 years, (72% male, 28% male) scars (20.6%) were felt to be visible by patients; 31 scars (10.5%) were rated> 1 on a scale of 1 to 5 and 12 scars (4%) were rated> 2. The average age of patients was highest for those patients with invisible scars, and the lowest average ag A was higher proportion of patients who complained of discomfort during suture removal also complained of marked scarring. CONCLUSION: In view of the low percentage of patients who complained of marked scarring, scarring should not be the main ground for deciding the approach to DCR surgery, particularly in older patients. These results are valid for the population that was studied and may be different for different racial backgrounds.