Congenital Lacrimal Fistula

Congenital lacrimal fistula (lacrimal–cutaneous fistula) is an epithelium-lined tract extending from the common canaliculus or lacrimal sac to the overlying skin surface. It usually presents as a small dimple medial to the eyelids and may be difficult to detect in the absence of symptoms (Fig 19-2). It is not always patent. If the patient is asymptomatic, no treatment is necessary. Discharge from the fistula is often associated with distal NLDO and may cease after probing of the distal obstruction. If discharge persists despite a patent lacrimal duct, surgical excision of the fistula between the skin and normal lacrimal structures is required.

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.