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May 2004

Ectopic Lacrimal Gland vs Ectopic Lacrimal Ductule

Arch Ophthalmol. 2004;122(5):791. doi:10.1001/archopht.122.5.791-b

McCulley and associates1 describean intriguing case of ectopic cilia with presumed lacrimal gland secretionthrough an anomalous lacrimal ductule misdirected to the external eyelid.There is, however, another possibility that should be entertained in the differentialdiagnosis. Ectopic cilia may contain functioning lacrimal gland as a complexchoristoma that is not discernable without histopathologic examination. Whenwe first described this entity in 1991,2 wethought that it was a rare anomaly, but we have since seen other cases presentedby colleagues. Presumably, the ectopic lacrimal gland at the base of the aberrantcilia is directed by the same neuronal control as the normal lacrimal glandand functions with the same reflex secretion. The case presented by McCulleyet al may in fact represent an anomalous lacrimal gland ductule, but withectopic cilia there is also the possiblity of ectopic lacrimal gland tissue.