A flexible endoscope includes an elongate flexible extrusion. A central lumen extends longitudinally through the center of the extrusion, and a plurality of other longitudinally extending lumens are spaced around the central lumen. An optical fiber is inserted within the central lumen and is coupled to its inner surface. This optical fiber serves as a compression member and conveys light through the flexible endoscope. A first pair of tension members extend through lumens on opposite sides of the central lumen. Applying a tension force to one of these tension members causes a distal tip of the flexible endoscope to bend in a first direction, while applying a tension force to the opposite tension member causes the distal tip to bend in an opposite direction. Providing a second pair of tension members in lumens disposed orthogonal to the first pair enables bending of the distal tip relative to orthogonal axes.