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Middle East Afr J Ophthalmol. 2018 Jul-Dec;25(3-4):170-172. doi: 10.4103/meajo.MEAJO_102_16.

Punctal Plug as a Treatment Option for Dry Eye Associated with Congenital Supernumary Puncta.

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Oculoplastic Division, King Khaled Eye Specialist Hospital, Riyadh 12329, Saudi Arabia.
Department of Ophthalmology, Rio Hortega University Hospital, 47012, Valladolid, Spain.
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto-University of São Paulo, Brazil.
Department of Ophthalmology Faculdade de Medicina de Botucatu- UNESP, São Paulo, Botucatu, SP, 18607-621, Brazil.


This study aims to describe a case of double lower lacrimal punctum-canaliculi in a dry eye patient treated with a punctal plug. A 60-year-old healthy female presented with complaints of tearing, itchy eyes, and foreign body sensation in the right eye for many years. There was no history of trauma or inflammation. Two patent independent supernumerary puncta and canaliculi were present on the right lower eyelid. The Schirmer Test II (with anesthesia) was zero, the tear breakup time was 2 s, and superficial punctate erosions were present in the right eye. A long-term nonabsorbable punctal plug was inserted into one of the lower puncta. At 9-month follow-up, the dry eye symptoms decreased markedly, the Schirmer Test II improved and superficial keratitis resolved.


Congenital; double puncta-canaliculi; dry eye; lacrimal drainage; punctal plug

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