Background: To report a case of mirror unilateral lacrimal fistula in monozygotic twins and to review the literature.\r\nMaterials and Methods: Full ophthalmic examination including pupillary light reflex, Hirschberg test, ocular\r\nmovements, face photographs was performed. Pediatrics consultation was requested.\r\nResults: We report an identical twins, 6-months age - boys, with unilateral lacrimal fistula. For each twin, there\r\nwas lacrimal fistula, located on the right for the first twin and on the left for the second one. The parents noted that the\r\npits were present since birth. It was asymptomatic in each twin from the outside. There were no ocular and systemic\r\nassociations with fistula.\r\nConclusion: We report first case to our knowledge of mirror unilateral lacrimal fistula in monozygotic twins.
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