A congenital lacrimal fistula is a rare developmental anomaly, usually unilateral. While it is often asymptomatic, some patients present with epiphora or discharge. We report the case of a 4-year-old boy with bilateral lacrimal fistulae. No other systemic, nasal, or ocular anomalies were found. In the absence of significant symptoms, we decided on a course of observation. In this article, we discuss the embryologic basis of congenital lacrimal fistulae, as well as the typical presentation and possible treatment modalities. The presence of a lacrimal fistula is an indication to search for a variety of underlying systemic and ocular anomalies.
A congenital lacrimal fistula is a rare developmental anomaly that is caused by an interruption in the embryogenesis of the nasolacrimal system. While it is often asymptomatic, some patients present with epiphora or discharge that requires surgical intervention. Rasor described the first reported case of congenital lacrimal fistula in 1675.1 To the best of our knowledge, no case of congenital lacrimal fistula has been reported in the otolaryngology literature.