Dr.MAYANK RAI
Accessory puncta is a congenital anomaly in which there is more than one lacrimal puncta, are mostly asymptomatic but can cause dry eye, epiphora and canaliculitis. A 12 year old male child came to our hospital with complaint of watering from left eye since 2 months. Slit lamp examination showed an round opening of size 0.2mm ×0.2mm present in the lower lid just lateral to lacrimal papillae having lower lacrimal punctum. With lacrimal passage irrigation finding showing patent upper and accessory punctum and blocked lower punctum probing through which showed soft stop following which diagnosis of Left eye accessory lacrimal punctum lower lid with lower canalicular block was made. Wicherkiewicz has reported the incidence of multiple puncta as 1 in 60000 eyes. A study done by Satchi K et al reports the diagnosis of only 23 patients over period of 20 years. Hence this presentation is not only rare but also demands usage of appropriate investigations to rule out any other pathology.
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