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Area of Science:

  • Ophthalmology
  • Anatomy

Background:

  • Double lacrimal puncta are a rare anatomical variation.
  • These variations can be asymptomatic or associated with ocular surface symptoms.

Purpose of the Study:

  • To describe two adult cases of double lacrimal puncta.
  • To highlight the clinical presentation and diagnostic approach for accessory puncta.

Main Methods:

  • Case report of two adult patients with double lacrimal puncta.
  • Clinical examination including lid eversion and nasolacrimal irrigation.
  • Surgical intervention (dacryocystorhinostomy and silicone intubation) for one patient.

Main Results:

  • One patient was asymptomatic; the other presented with epiphora.
  • Accessory puncta were unilateral, infra-positioned, and medially located.
  • Nasolacrimal drainage obstruction was identified in the symptomatic patient.

Conclusions:

  • Double lacrimal puncta can be linked to epiphora and dry eye.
  • These findings may be overlooked in routine examinations.
  • Lid eversion is a simple diagnostic tool for identifying supernumerary puncta.