title: Centurion syndrome. Idiopathic anterior displacement of the medial canthus.
abstract: OBJECTIVE
  To describe a series of patients with epiphora due to a medial canthal anomaly. This anomaly consists of an anterior displacement of the anterior limb of the medial canthal tendon and a prominent nasal bridge, with lid malposition away from the globe and displacement of the lacrimal puncta out of the tear lake. The authors use the term Centurion syndrome to describe this anomaly.
  
  
  METHODS
  The history, results of examination, investigations, and surgical management and outcome of 13 patients with Centurion syndrome were reviewed. Seven patients were recalled for examination to complete patient details.
  
  
  RESULTS
  All patients had epiphora since childhood, which worsened at puberty, and all were patent to syringing. Lacrimal scintillography (ten cases) showed a functional block at the inner canthus, with hold up of activity before entry into the sac. Surgery to restore lid globe apposition medially by release of the anterior limb of the medial canthal tendon (eight patients), sometimes combined with dacryocystorhinostomy (four patients), relieved the epiphora.
  
  
  CONCLUSIONS
  There is a group of patients with unexplained epiphora due to a medial canthal anomaly, which the authors have termed Centurion syndrome. It is important to recognize this anomaly, as it can be corrected surgically by medial canthal tendon release or by medial canthal tendon release combined with dacryocystorhinostomy if there is concomitant lacrimal outflow obstruction.
authors.affiliation: Lacrimal Clinic, Moorfields Eye Hospital, London.
authors.forename: T J
authors.initials: TJ
authors.lastname: Sullivan
authors.forename: R A
authors.initials: RA
authors.lastname: Welham
authors.forename: J R
authors.initials: JR
authors.lastname: Collin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003608:Dacryocystorhinostomy; D005143:Eyelids / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000000981:diagnostic imaging; D007766:Lacrimal Apparatus Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D011877:Radionuclide Imaging; D013577:Syndrome