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Bilateral simultaneous pyogenic granuloma after perforated punctal plug insertion.

Osama H Ababneh¹, Mohammed M Msallam

¹Department of Ophthalmology, The University of Jordan, and Jordan University Hospital, Amman, Jordan.

Ophthalmic Plastic and Reconstructive Surgery

|November 8, 2013

Summary

Recurrent adenoviral keratoconjunctivitis caused punctal stenosis and excessive tearing. Silicone punctal plugs initially helped but led to pyogenic granuloma, requiring removal and treatment.

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Area of Science:

Ophthalmology
Infectious Diseases

Background:

Adenoviral keratoconjunctivitis can lead to chronic ocular surface disease.
Punctal stenosis is a potential complication causing epiphora (excessive tearing).

Observation:

A 44-year-old woman presented with bilateral excessive tearing due to punctal stenosis.
Initial treatment involved perforated silicone punctal plugs, which provided temporary relief.

Findings:

The punctal plugs caused a foreign-body sensation due to pyogenic granuloma formation.
Removal of the plugs and topical steroid-antibiotic treatment resolved the foreign-body sensation.

Implications:

This case highlights a rare complication of punctal plug use in patients with recurrent viral eye infections.
Careful monitoring is needed when using punctal plugs in complex ocular surface conditions.