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Updated: May 15, 2026
Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
Acquired lacrimal sac fistula mimicking basal cell carcinoma
A S Litwin1, H Timlin, S Sagili
1Corneoplastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, West Sussex RH19 3DZ, UK.
Background:
Lacrimal sac fistulae can arise after an episode of dacryocystitis, usually forming below the medial canthus. Preceding symptoms of a watery eye with mucous discharge and a history or signs of inflammation are typical.
Objectives:
To highlight the features of lacrimal sac fistulae and encourage readers to consider this in the differential diagnosis of apparently ulcerative medial canthal skin lesions.
Methods:
We describe three patients with inferior-medial canthal ulcerative skin lesions, all referred to ophthalmic plastic surgeons either by dermatologists or plastic surgeons, presumed clinically to have basal cell carcinoma (BCC).
Results:
All three were in fact due to acquired lacrimal sac fistulae, and syringing of the nasolacrimal system confirmed the presence of a fistula.
Conclusions:
These cases illustrate the importance of questioning patients about their previous ocular symptoms when dealing with less familiar periocular lesions.
