1. Dacryocystogram (DCR) Danielle Howery is awesome!!!

2. Lacrimal Gland The lacrimal gland produces tears which keep the eye moist. The tears enter the eye from the upper outer sector of the eye The tears travel through the tear drainage system into the nose.

3. Blocked Lacrimal Gland Sometimes, the lower tear duct becomes blocked. This produces a watery eye. Correction of a blocked tear duct requires surgery.

4. Patient Scenario  This 59 year-old woman had had bilateral endonasal dacryocystorhinostomy (DCR).  She was symptom free for about 6 months, but returned to the clinic recently complaining of right epiphora.  There was a blockage in the right side but left side was fine.  She later underwent DCR with good result.

5. Left DCG showing lacrimal sac filling followed by spillage of the dye into the nasal cavity through the dacryocystorhinostomy

6. Right DCG showing lacrimal sac filling without drainage into the nasal cavity. In the last frame, dye shows up in the lower lid margin from regurgitation.

7. CT scan showing normal osteomeatal complex. Sinuses are well ventilated. CT scan showing normal osteomeatal complex. Sinuses are well ventilated.

8. CT scan showing rhinosinusitis with a blocked osteomeatal complex and secondary infection in the maxillary sinuses. CT scan showing rhinosinusitis with a blocked osteomeatal complex and secondary infection in the maxillary sinuses.

9.  Findings: Serial axial images through the orbit without contrast show bilateral masses involving the lacrimal glands and extending both superiorly and laterally to the globe. Bilateral protrusion of the eyeballs is noted.  Clinical History: 65 year old male with bilateral orbital masses and a history of non- Hodgkin’s lymphoma and lung carcinoma.

10.  Diagnosis: Bilateral lacrimal gland enlargement.  Benign lymphoid

11. Epiphora

14. The LacriCATH® balloon catheter has revolutionized the treatment of nasolacrimal duct obstruction in children and adults.

15. Lacrimal Dilator Inflation Device 9mm Transnasal Lacrimal Duct Balloon Catheter Balloon Catheter 5 mm Lacrimal Duct Balloon Catheter 3 mm Lacrimal Duct Balloon Catheter 2 mm Lacrimal Duct Balloon Catheter

16. Tear Duct Tubes Standard Set Assorted SetSpecial Set

18. Disorder Correction description price Gloucoma 700$ for each eye Cataract LASIK 700$ for both eyes Retinal Detachment Surgery Retinal Detachment Surgery1200$ Cornea transplant (Penetrating keratoplasty) Cornea transplant (Penetrating keratoplasty)1500$ Dacryocystorhinostomy (DCR) Dacryocystorhinostomy (DCR)600$ wwwtehranlasik.com/correction/Dacry.htm