Functional endoscopic sinus surgery (FESS) is an effective and safe surgical technique, which revolutionized the surgical management of nasal cavity and paranasal sinus diseases. The intimate connection between paranasal sinuses and the orbit places the orbital content at a risk of injury during sinus surgery, especially that of ethmoid sinuses. The orbit, the optic nerve, extraocular muscles and the lacrimal drainage system could be damaged during FESS. The risk of injury correlates to anatomical variations, degree and severity of disease, previous procedure results, and surgical experience. Ophthalmic complications can vary in severity from minor ones, such as localized hematomas, to extremely dangerous, such as optic nerve injury, that could lead to complete blindness. In order to minimize the risk of such complications, it is necessary to consider probable anatomic variations of paranasal sinuses and orbit, which are to be detected by CT scan before surgery.

Introduction. Radioactive iodine therapy after thyroidectomy is the standard of differentiated thyroid cancer treatment in the modern world. Main dose-dependent side effects described in the literature include: sialadenitis, xerostomia, taste and/or odor loss, swelling of surrounding tissues. Ophthalmic complications are rarely reported. Aim. To assess the lacrimal system condition in patients after radioactive iodine therapy for thyroid cancer. Material and methods. The study included 17 patients (34 eyes). There were female patients aged 19 to 43 years (mean age was 31 years) who underwent a course of radioactive iodine therapy for thyroid cancer. All of them complained of periodic or constant tearing in the period from 2 months to 1 year after therapy course. In four patients, there was a permanent or periodic mucopurulent discharge when pressing on the lacrimal sac area. All patients underwent a standard ophthalmological examination, including visual acuity testing, anterior segment biomicroscopy, ophthalmoscopy, and tear production tests. Dye disappearance test, Jones I and II tests, lacrimal pathways irrigation, and, if necessary, cone-ray computer tomography with preliminary lacrimal pathways contrasting were performed to evaluate the tear outflow abnormalities. Results. Tear production disorders were detected in 20 eyes (58.8%) (among them, moderate dry eye syndrome was diagnosed in 3 cases); tear outflow pathology was revealed in 14 eyes (41.2%) (namely naso-lacrimal duct obstruction and stenosis, and chronic purulent dacryocystitis). For patients with tear production pathology artificial tears were prescribed, and endoscopic endonasal dacryocystorhinostomy was performed in cases of tear outflow disturbances. Conclusion. The use of radioactive iodine in doses exceeding 80 mCi leads to the development of lacrimal system pathology: dry eye syndrome of various severity, and tear outflow disorders. Lacrimal system pathology significantly worsens the patient's quality of life, and the prophylaxis of these diseases before the radioactive iodine therapy course remains the imminent key problem. (For citation: Beldovskaya NYu, Karpishchenko SA, Baranskaya SV, Karpov AA. Lacrimal system pathology in patients with ­malignant thyroid tumors after radioactive iodine therapy, and its correction methods. ­Ophthalmology Journal. 2017;10(4):13-17. doi: 10.17816/OV10413-17).

Lacrimation is one of the most common symptoms in ophthalmic practice. Most patients first visit an ophthalmologist, but the otorhinolaryngologist also plays an important role in determining the etiology of the disease and in the choice of management for such patients. This review presents a literature search that addresses the diagnosis and treatment of patients with epiphora. Identifying the cause of lacrimation is the main factor in making the correct diagnosis and choosing the optimal treatment method. Endonasal dacryocystorhinostomy is of particular importance. The multidisciplinary approach of the ophthalmologist and otorhinolaryngologist allows for the success of the epiphora treatment.

Lacrimation or epiphora is one of the most common complaints in pediatric ophthalmic practice, indicating the presence of lacrimal duct obstruction. It is customary to distinguish between congenital or primary obstruction of the nasolacrimal duct the most common cause of lacrimation in newborns and children in the first year of life. Secondary or acquired dacryostenosis, characteristic of children from one year and older, most often has a rhinogenic origin, is more difficult to treat, and often leads to the development of complicated forms of the disease. Assessment of the cause of the epiphora is the key to making the correct diagnosis and choosing the optimal treatment tactics, conservative and/or surgical. A multidisciplinary approach, the interaction of an otorhinolaryngologist and an ophthalmologist is of great importance, which ensures the final successful result of lacrimation treatment in children.