Lacrimal Secretory System
Congenital abnormalities of the lacrimal gland are rare. Hypoplasia and agenesis of the lacrimal gland can occur in isolation or in conjunction with congenital abnormalities of the salivary glands. Both are usually sporadic but have been reported in an apparent autosomal dominant pattern. Ectopic lacrimal gland tissue can be present within the orbit and eyelids, and lacrimal gland prolapse is sometimes seen in patients with craniosynostosis syndromes.
Occasionally, children are born with an aberrant ductule that exits externally through the eyelid overlying the lacrimal gland; this was previously referred to as a lacrimal gland fistula. These aberrant ductules exit laterally several millimeters above the eyelash line and are usually accompanied by an adjacent cluster of eyelashes. Tears produced from the aberrant ductules can mimic epiphora. These ductules can be successfully managed with simple excision.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.