Demonstration of a Cutaneous Lacrimal Fistula

In this 1-Minute Video, Dr. Richard Allen demonstrates a cutaneous fistula of the lacrimal sac in a patient with a history of a congenital nasolacrimal duct obstruction (NLDO). Fluorescein is irrigated is through the lower punctum and canaliculus, and there is egress of fluid medially through the fistula. In addition, there is reflux into the eye through the other punctum demonstrating the NLDO. This video reinforces the importance of inspecting the medial canthus of all patients with congenital NLDO to ensure that there is no cutaneous fistula.

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