ABSTRACT
To report a very rare congenital lacrimal /disorder with controversy regarding its origin, difficulty in differential diagnosis, and management. Patients and methods: Six newborns with age range between two days and one month, were seen between 1986 and 1996. All had pinkish swellings inferior to the medial canthal tendon. One case was treated by hot soaks, massage, and local antibiotic. Two cases were seen with complicated mucoceles, and had developed erythema of the tissues overlying their distended lacrimal sacs. Those three patients were probed and irrigated under general anesthesia. The first of those three patients had bilateral congenital cataract, the other who presented with pointing infected sacs which were drained percutaneously Cultures from the aspirates of all sacs were done. None of the patients developed epiphora or needed probing later on. There was no fistula formation for those who were drained. In order to avoid inappropriate investigations and hasten treatment, congenital amniotocele must be diagnosed early and differentiated from other congenital masses in the area. Initially, amniotocele must be treated conservatively in the same way as congenital nasolacrimal duct obstruction, but if the conservative treatment fails or if the patient is referred with infected sac, probing is recommended