Misplaced cilia in lacrimal punctum presenting as allergic conjunctivitis- A case series

Abstract

Background- Normally shed eye lashes (cilia) sometimes get dislodged in lacrimal punctum causing symptoms resembling allergic conjunctivitis. If not diagnosed it may lead to improper treatment and complications. Purpose- To describe a series of cases of misplaced cilia in lacrimal punctum who were misdiagnosed and treated as unilateral allergic conjunctivitis. Method- The study included 8 patients who presented with symptoms of allergic conjunctivitis and were found to have misplaced cilia in their lower or upper lacrimal punctum. In all patients, cilia were removed with plain forceps under slit lamp. Results- There were 8 patients (6 males and 2 females). Mean age of patients were 28.44+/-4.27 years. Mean duration of symptoms (ocular irritation, watering and redness) were 5.25+/- 2.37 days. All patients were treated with topical anti allergic and lubricating eye drops before presenting to us. Five patients had cilia in upper punctum and 3 patients had it in lower punctum. In all patients, after removal of cilia from punctum, all symptoms were resolved promptly. Conclusion- In patients presenting with symptoms of allergic conjunctivitis, eyelid margin should be examined carefully and presence of cilia in the punctum should be specially looked for.