Supernumerary Punctum With Its Own Distinct Canaliculus.

Supernumerary punctum is a rare congenital lacrimal drainage disorder that occurs secondary to the development of multiple epithelial buds from the proximal end of the lacrimal cord during embryogenesis. Their location is usually along the canalicular tract, medial conjunctival fornix, or caruncle. Supernumerary puncta have been reported in several lacrimal drainage and systemic disorders. Anterior segment optical coherence tomography is being increasingly employed to study their characteristics. The normal punctum and the supernumerary punctum on the same eyelid are usually reported to have a common horizontal canaliculus. The present case demonstrates the presence of 3 canaliculi in 1 eye: 1 upper and 2 individual lower canaliculi arising from the normal and the supernumerary punctum.