Epiphora due to compression of the lacrimal sac by a supernumerary blind sac

A 23-year-old male had suffered from epiphora in the left eye since childhood. There was no history of infection or trauma. A supernumerary punctum was seen in the left lacrimal caruncle on examination. Subsequent dacryocystography and computer tomography showed a blind-ended sac that was connected to the supernumerary punctum, but not to the normally developed nasolacrimal system. When distended with secretion, this blind-ended lacrimal sac caused compression and obstruction of the normal lacrimal drainage pathway, which led to epiphora. The epiphora disappeared after surgical removal of the supernumerary system.