Congenital lacrimal fistula presenting in adulthood: A case series

Congenital lacrimal fistulas with secondary infection mimicking acute dacryocystitis: a case report and literature review

“…The rate of bilateral lacrimal fistula increased when associated with familial inherited [8] or syndromal cases [9][10][11] . Most of the fistulas are asymptomatic, non-progressive and inconspicuous due to their small size and lack of pigmentation around, and therefore are frequently overlooked [12] . Symptomatic cases may present with epiphora or mucoid discharge from the fistula [8,13] , the eye or both when associated with functional or anatomical nasolacrimal duct obstruction.…”

“…Symptomatic cases may present with epiphora or mucoid discharge from the fistula [8,13] , the eye or both when associated with functional or anatomical nasolacrimal duct obstruction. In very rare cases, the lacrimal fistulas suffer to secondary infection, and present redness, swelling and pain at the medial canthal region [3,12] , mimicking acute dacryocystitis. In our case, the patients with recurrent cellulitis secondary to fistulitis were firstly misdiagnosed as acute dacryocystitis, and treated with repeated stab incision and drainage.…”

“…Fistulectomy alone is preferable and much more effective than simply cutting or cauterizing the ostium of the fistula in patients who had no evidence of nasolacrimal obstruction [23][24] . This approach has shown excellent success rates ranging from 91% to 100% [7,12] . The recurrence was attributed to incomplete excision of the epithelial lining of the fistula [6,25] .…”