Figure 1

Clinical profile of balloon variant of incomplete punctal canalization external membrane variety. Slit lamp photograph of the right lower lid showing an avascular, elevated and translucent membrane covering the puncta (arrow) (a). Intraoperative photograph of the same patient showing the dome-shaped elevation with slopes contiguous with the tarsal conjunctiva (arrow) (b). Intraoperative photograph showing the process of membranotomy with a Nettleship’s punctum dilator (c). Intraoperative photograph following membranotomy. Note the wide punctal opening (arrow) (d). Intraoperative photograph showing a probe in the normal canaliculus (e). Microphotograph of the membrane showing fibrocollagenous tissue with few vascular channels without any evidence of inflammation suggestive of fibrovascular membranes (hematoxylin and eosin x400) (f).