TNOA Journal of Ophthalmic Science and Research

: 2021  |  Volume : 59  |  Issue : 3  |  Page : 313-

Supernumerary punctum

Carlos Izquierdo-Rodriguez 
 Department of Ophthalmology, Hospital Universitario del Henares; Department of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain

Correspondence Address:
Dr. Carlos Izquierdo-Rodriguez
Hospital Universitario Del Henares, Avda Marie Curie s/n, 28822 – Coslada, Madrid

How to cite this article:
Izquierdo-Rodriguez C. Supernumerary punctum.TNOA J Ophthalmic Sci Res 2021;59:313-313

How to cite this URL:
Izquierdo-Rodriguez C. Supernumerary punctum. TNOA J Ophthalmic Sci Res [serial online] 2021 [cited 2022 Sep 26 ];59:313-313
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Full Text

An 84-year-old woman with chronic bilateral tearing is reported.

Supernumerary tear point is a rare congenital anomaly. It may be asymptomatic throughout life or have symptoms of epiphora.[1]

It is most often located in the lower eyelid and opens into a normal or a supernumerary canaliculus.[2]

Most often, it is asymptomatic although it can manifest as epiphora or dry eye syndrome.

Slit lamp examination revealed two tear points on the upper right eyelid. The lower eyelid showed a single lacrimal punctum. The upper lateral punctum was anatomically normal, and the medial puncta has been epithelialized [Figure 1]. Examination of the tear ducts showed that lateral punctum is functional and communicates with the tear sac but was flowing back through the inferior lacrimal point. The upper medial punctum was not functional and ended in a cul-de-sac, but the lower puncta and de upper lateral punctum were communicated.{Figure 1}

This case had an upper and lower tear point communicated with the lacrimal sac, but with an obstruction of the nasolacrimal duct.

Declaration of patient consent

The author certifies that he has obtained all appropriate patient consent forms. In the form, the patient has given consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.


1Timlin HM, Keane PA, Ezra DG. Characterizing congenital double punctum anomalies: Clinical, endoscopic, and imaging findings. Ophthalmic Plast Reconstr Surg 2019;35:549-52.
2Satchi K, McNab AA. Double lacrimal puncta: Clinical presentation and potential mechanisms of epiphora. Ophthalmology 2010;117:180-300.