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   Table of Contents      
Year : 2020  |  Volume : 68  |  Issue : 1  |  Page : 205

Characterizing supernumerary lacrimal punctum by anterior segment optical coherence tomography imaging

1 Department of Orbit and Oculoplasty, Disha Eye Hospital, Kolkata, West Bengal, India
2 Department of Cornea and Ocular Surface, Disha Eye Hospital, Kolkata, West Bengal, India

Date of Web Publication19-Dec-2019

Correspondence Address:
Dr. Joyeeta Das
176 Madurdaha, Jeet Solitaire, Flat No 3B, Kolkata - 700 107, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_576_19

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How to cite this article:
Das J, Das N. Characterizing supernumerary lacrimal punctum by anterior segment optical coherence tomography imaging. Indian J Ophthalmol 2020;68:205

How to cite this URL:
Das J, Das N. Characterizing supernumerary lacrimal punctum by anterior segment optical coherence tomography imaging. Indian J Ophthalmol [serial online] 2020 [cited 2020 Sep 19];68:205. Available from: http://www.ijo.in/text.asp?2020/68/1/205/273255

Supernumerary puncta is an uncommon congenital anomaly where multiple puncta are present in one eyelid formed by multiple epithelial budding of lacrimal cord opening along canaliculus, caruncle, and conjunctiva during embryogenesis.[1],[2]

Slit-lamp examinations of left lower lid found presence of two puncta [Figure 1]a of a 44-year-old gentleman. Spectral domain anterior-segment OCT [SD-ASOCT] imaging of puncta [3] by RTVue model-RT100 CAM -system [Optovue Inc., Fremont CA, USA] showed two funnel shaped tissue gap corresponding cross-sectional image of supernumerary puncta [Figure 1]b. To the best of our knowledge, this is the first report of AS-OCT of supernumerary puncta in medical literature.
Figure 1: (a) Slit-lamp photography of supernumerary puncta of left eye lower lid, normal healthy puncta [black solid arrow], supernumerary puncta [solid white arrow]. (b) Cross-sectional image of both puncta obtained by AS-OCT, the deep funnel shaped hyporeflective spaces [solid white arrow] is normal healthy puncta. The hyperreflective epithelium of lid margin is continuous in both wall but abruptly thinned out at the margin of opening at temporal wall though nasal wall epithelium maintain its thickness throughout whole vertical depth. The shallow creeping edged tissue gap buried in the lid margin defines supernumerary puncta [asterix]. Here, lid margin epithelium is discontinuous in both the wall

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names 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.

  References Top

Veirs E. Congenital abnormalities. In: Veirs E, editor. Lacrimal Disorders: Diagnosis and Treatment. Saint Louis: The C V Mosby Company; 1976. p. 48-9.  Back to cited text no. 1
Mackenzie W. A Practical Treatise on the Disease of the Eye. 4th ed. London: Boston, Carter, Hendee; 1854.  Back to cited text no. 2
Allam RS, Ahmed RA. Evaluation of the lower punctum parameters and morphology using spectral domain anterior segment optical coherence tomography. J Ophthalmol 2015:591845.  Back to cited text no. 3


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