Supplementary Material for: Large Number of Eyelashes in the Lacrimal Sac Found by Dacryoendoscopy: A Case Report

Foreign objects sometimes enter the lacrimal sac. Here, we report the case of a patient with many comb-shaped eyelashes in the lacrimal sac and discuss the potential of using dacryoendoscopy to detect and remove foreign bodies from the lacrimal apparatus. A 65-year-old woman with a teary eye underwent dacryoendoscopy. There was no abnormality in the canaliculi. The internal ostium was blocked by a large number of black, comb-shaped eyelashes. Numerous bunched eyelashes covered with small white debris were found in the upper part of the lacrimal sac. No eyelash bundles were present from the lower lacrimal sac to the nasolacrimal duct, and the mucosa was normal. The saline was able to pass through; however, the lower part of the nasolacrimal duct was narrowed into a funnel shape. We widened it with a sheath while observing the endoscopy images. Eyelashes were flushed from the lacrimal sac through the nasolacrimal duct using the sheath and saline flow. A lacrimal tube was placed for 2 months and removed, and then the patient healed without dacryocystorhinostomy.