Supernumerary Puncta

  • Mohammad Javed Ali


Supernumerary puncta are uncommon lacrimal anomalies. They possibly result from multiple epithelial buds developing from the upper end of the lacrimal cord in an 18–24 mm embryo [1–3]. The incidence of supernumerary puncta and canaliculi is estimated to be 1 in 60,000. Their location can be along the line of canaliculus or caruncle or medial conjunctival cul-de-sac. Epiphora is the common complaint and is usually due to associated lacrimal anomalies or secondary to reflux of tears through the accessory punctum. These are known to be associated with lacrimal anomalies like nasolacrimal duct obstruction, lacrimal fistula, lacrimal sac diverticulum, and monocanalicular agenesis. Systemic associations known are Down’s syndrome and preauricular sinus [1–3].


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    Wicherkiewicz W. Proceeding of XI International Congress of Medicine, vol. 6. Rome, 1895; p. 49.Google Scholar
  3. 3.
    Satchi K, McNab AA. Double lacrimal puncta: clinical presentation and potential mechanisms of epiphora. Ophthalmology. 2010;117:180–3.CrossRefPubMedGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Mohammad Javed Ali
    • 1
  1. 1.Govindram Seksaria Institute of Dacryology (GSID)L.V. Prasad Eye InstituteHyderabadIndia

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