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The child with epiphora.

ANATOMICAL CONSIDERATIONS The nasolacrimal excretory apparatus (Figure 1) develops as a solid cord of cells that canalizes relatively late in gestational life. This hollowing process begins at the middle and proceeds to both ends, explaining why nasolacrimal duct obstruction is due most commonly to impatency at the bottom of the nasolacrimal duct as it enters the nose (Figure 1) or at the top where the puncta may be found to be impatent (Figure 1).