Canalicular Cyst After Punctal Plug Insertion

Area of Science:

• Ophthalmology
• Oculoplastics

Background:

• Punctal plugs are commonly used to treat dry eye syndrome by occluding the tear drainage system.
• Complications from punctal plugs are rare but can occur, necessitating awareness among clinicians.

Observation:

• A 73-year-old male presented with a cystic mass on the medial aspect of the right lower eyelid.
• The patient had a history of bilateral punctal occlusion with absorbable punctal plugs 8 years prior.
• The mass was palpable, associated with ectropion, but lacked inflammatory signs.

Findings:

• Incisional drainage provided temporary relief, but further investigation was required.
• Dacryocystography demonstrated cystic dilation of the right lower canaliculus.
• Lacrimal probing confirmed canalicular obstruction, leading to the diagnosis of a canalicular cyst.

Implications:

• This case highlights a rare but significant complication of punctal plug use.
• Canalicular cysts should be considered in the differential diagnosis for medial canthal masses in patients with a history of punctal occlusion.
• Ophthalmologists should be vigilant for this potential sequela, especially in patients presenting with eyelid masses near the punctum.