Lacrimal Anomalies in Robinow's Syndrome

To the Editor. —Robinow's (fetal face) syndrome is a form of mesomelic dwarfism characterized by hypoplastic genitalia; atypical facies, with a flat profile, prominent forehead, hypoplastic mandible, hypertelorism, long philtrum, and short, flat upturned nose; and an increased tendency for infections. 1 We herein report a case of Robinow's syndrome with bilateral atresia of the ostium lacrimale and absent upper lacrimal canaliculi and puncta. Report of a Case. —A 9-month-old black female infant with a negative family history and bilateral epiphora since birth had macrocrania, a large anterior fontanelle, frontal bossing, hypertelorism, a small mouth, a flat facial profile, a long philtrum (Fig 1), hyperplastic alveolar ridges, a small upturned nose, a hypoplastic clitoris, short forearms, absence of the upper lacrimal puncta, and bilateral chronic purulent dacryocystitis. Refraction and slit-lamp biomicroscopic, ophthalmoscopic, and tonometric examinations were otherwise unremarkable. After ten days of conservative treatment, she developed a Streptococcus pneumoniae , acute