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I read with interest the case report by McCulley et al¹ in the November 2002 issue of the ARCHIVES. The authors state, "To our knowledge, this is the first reported case of abnormal tear drainage due to lacrimal gland secretion through a lacrimal ductule misdirected to the external eyelid." The condition has already been thoroughly described, including the embryologic origin of the anomaly. We reported a case in the Journal of Pediatric Ophthalmology and Strabismus² in 1994 and specifically referenced Blanksma and van de Pol's³ description of the tarsal group, which has the orifice near the superior edge of the tarsal plate of the upper eyelid and is always associated with a tuft of lashlike hairs exiting from the orifice.

Martin S. Cogen, MD
Birmingham, Ala

1. McCulley TJ, Yip CC, Kersten RC, Kulwin DR. An ectopic site of lacrimal gland secretion mimicking epiphora. Arch Ophthalmol. 2002;120:1586-1587. FREE FULL TEXT 2. Cogen MS, Lewis AR, Kelly AG. Anomalous lacrimal ductule: case report and review. J Pediatr Ophthalmol Strabismus. 1994;31:327-329. PUBMED 3. Blanksma LJ, van de Pol BA. Congenital fistulae of the lacrimaal gland. Br J Ophthalmol. 1980;64:515-517. FREE FULL TEXT

Arch Ophthalmol. 2004;122:791.

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Lacrimal Gland Secretion Mimicking Epiphora—Reply
Timothy J. McCulley
Arch Ophthalmol. 2004;122(5):791-792.
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