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.


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