1, congenital tear atresia The tear dots opening is too small or covered by epithelium, the tear ducts can be normal. If the tear duct opening is too small, the tear duct can be dilated with a tear duct dilator. In cases of lacrimal atresia, a small concavity can usually be seen in the middle of the lacrimal duct, which can be explored or incised from the small concavity. 2. Double lacrimal dots and double lacrimal ducts Two lacrimal dots and two lacrimal ducts in the eyelid that enter the lacrimal sac can be left untreated. 3. Congenital lacrimal sac fistula The opening of the lacrimal sac appears on the outside of the nose, below the medial canthal ligament, either unilaterally or bilaterally. The painful area flows clear fluid and can be closed by cautery or surgically removed.