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Case Report

A rare case of complete acquired atresia of lacrimal sac and nasolacrimal duct

1Assistant Professor, 2Professor, 3Professor and Head, Department of Ear Nose and Throat, 4Professor and Head, Department of Ophthalmology, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana State, India.


A 23 Year old lady presented with watering form left eye since 10-12 years. Probing revealed hard stop, and syringing the lacrimal apparatus revealed regurgitation of saline from opposite punctum .she was taken up for Endonasal dacrocystorhinostomy under general anesthesia .During surgery lacrimal fossa was explored but neither the lacrimal sac nor the lacrimal duct could be found, after removing the lacrimal bone and therefore surgery was terminated. Syringing in post operative period revealed partial regurgitation of saline from upper punctum on operated side, and partially reaching oropharynx and there is decrease in epiphora .Then in post operative period ,we reviewed the CT scan which was showing empty lacrimal fossa.

This case is reported for its surprising improvement of symptoms in post operative period inspite of absence of lacrimal sac and termination of surgery.

Key Words: Acquired atresia of lacrimal sac, Acquired atresia of nasolacrimal duct, Endo-nasal dacrocystorhinostomy, Lacrimal sac atresia, Nasolacrimal duct atresia.