Canaliculitis in supernumerary puncta and canaliculi

Area of Science:

• Ophthalmology
• Anatomy

Background:

• Supernumerary puncta and canaliculi are rare congenital anomalies of the lacrimal system.
• Canaliculitis is an inflammation of the lacrimal canaliculus, often caused by bacterial or fungal infections.

Observation:

• A 59-year-old male presented with a one-week history of painful swelling and epiphora in the left lower eyelid.
• Examination revealed two puncta, with the inner, abnormally located punctum being patent and the outer, normally positioned punctum being a cul-de-sac.
• The swelling was localized to the nasal aspect of the lower eyelid with inflamed overlying skin.

Findings:

• The case describes the first instance of supernumerary puncta and canaliculi associated with canaliculitis.
• Embryological review suggests a mechanism for the anomalous patency of the supernumerary punctum.
• The pathomechanism leading to canaliculitis in this anatomical variation was elucidated.

Implications:

• This case expands the understanding of lacrimal system anomalies and their clinical presentations.
• It highlights the importance of thorough examination of the lacrimal puncta in cases of eyelid swelling and epiphora.
• The findings contribute to the knowledge of canaliculitis pathogenesis in rare anatomical variations.