Anatomical variations of the nasolacrimal system
Reviewed by Hevti Bhatt

The authors report a retrospective observational case series of 734 dacryocystography images; 689 from adult patients and 45 from paediatric patients. Of these 734 images, 35 (4.8%) were found to have an anatomical variant where the nasolacrimal duct emerged from the medial wall of the lacrimal sac rather than directly inferior. The importance of this anatomical variation is yet to be determined, although the authors postulate that it may result in difficulty intubating from anecdotal experience. Interestingly, all but one patient with this variation were patent on syringing, and some patients with bilateral anatomical variation were only symptomatic in one eye, thereby making it difficult to determine clinical significance.

High nasolacrimal sac-duct junction anatomical variation - retrospective review of dacryocystography images.
Juniat V, Lee J, Sia P, Curragh D, et al.
ORBIT
2021;40(6):505-8.