AAO 2019 Video Program

    Congenital lacrimal fistula is a rare developmental anomaly with an accessory duct originating from the lacrimal drainage system and opening into the skin. It is frequently unilateral and may be isolated, or it can be associated with anatomical abnormalities of the lacrimal apparatus and systemic conditions. There are various treatment modalities, including lacrimal duct probing, cauterization and fistulectomy with or without dacryocystorhinostomy. In this video we discuss the etiopathogenesis, classification, clinical features and histopathology of congenital lacrimal fistula and demonstrate a simple technique of closed fistulectomy in a child with patent nasolacrimal duct. This surgery, if performed with patience and precision, can achieve complete excision of the fistulous tract with good anatomic and functional outcome.