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We took interest in the case report of McCulley et al¹ pertaining to the ectopic site of lacrimal gland secretion. The patient described had a lacrimal ductule misdirected to the external eyelid. The authors comment that this is the first reported case of such a ductule of which they are aware. However, in 1980 a similar presentation was noted and termed a lacrimal gland fistula. ²

The patient in the earlier article² was an 8-year-old girl with a history of epiphora in the left eye since at least the age of 1 year. Whether this lacrimal gland fistula was congenital was questionable because the patient had a history of trauma to that eyelid at age 9 months. She had been evaluated multiple times for the epiphora, but it was not until the age of 7 years that the fistula was noted. Another surgeon treated the fistula at that time by excision . . . [Full Text of this Article]

Allen Putterman, MD; Marc Shields, MD
Chicago, Ill