Punctal agenesis: Embryology, presentation, management modalities and outcomes

Jenny C Dohlman; Larissa A Habib; Suzanne K Freitag

doi:10.1016/j.aanat.2019.04.004

Punctal agenesis: Embryology, presentation, management modalities and outcomes

Ann Anat. 2019 Jul:224:113-116. doi: 10.1016/j.aanat.2019.04.004. Epub 2019 May 16.

Authors

Jenny C Dohlman¹, Larissa A Habib², Suzanne K Freitag²

Affiliations

¹ Massachusetts Eye and Ear Infirmary, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA. Electronic address: jenny_dohlman2@meei.harvard.edu.
² Massachusetts Eye and Ear Infirmary, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.

PMID: 31102704
DOI: 10.1016/j.aanat.2019.04.004

Abstract

Punctal agenesis is defined as the absence of the punctum occurring secondary to a failure of embryogenesis. This review synthesizes existing data on the embryology, anatomy, clinical presentation, symptomatology, management options and treatment outcomes of punctal agenesis. A foundational knowledge of the underlying embryologic and anatomical abnormalities is fundamental to understanding its clinical presentation and assists in choosing an appropriate management strategy. Existing outcomes data is generally favorable and suggests management with a step-wise approach can alleviate symptoms in patients across a spectrum of disease.

Keywords: Absent punctum; Embryogenesis; Lacrimal anomaly; Lacrimal punctum; Lacrimal system; Punctal agenesis.

Publication types

Review

MeSH terms

Humans
Lacrimal Apparatus / abnormalities*
Lacrimal Apparatus / anatomy & histology
Lacrimal Apparatus / embryology*
Lacrimal Apparatus Diseases* / embryology
Lacrimal Apparatus Diseases* / etiology
Lacrimal Apparatus Diseases* / therapy
Treatment Outcome

Supplementary concepts

Lacrimal Puncta, Absence of