Lacrimal sac plugging caused by Aspergillus fumigatus

Aspergillus fumigatus is a rare cause of canalicular obstruction. We present a case where an aspergillosis plug caused extreme tenderness, epiphoria and discharge from the lacrimal puntum. CT scan showed dilation of the lacrimal sac. Medical treatment did not relieve the symptoms. During a planned DCR the sac was opened before the osteotomy, and found to contain a plug which caused the obstruction. Aspergillus fumigatus was grown from culture. The DCR was abandoned and the patient is symptom free one year after the procedure.