Wolfring dacryops: a case of acquired ptosis in a child

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A healthy, nine-year-old boy presented to the oculofacial plastic service with left upper eyelid ptosis progressively worsening for the past two years. On eyelid eversion, a cystic mass was found on the medial palpebral conjunctiva. Magnetic resonance imaging confirmed a fluid-filled cystic structure without posterior orbital extension. Based on imaging and clinical findings, the patient was diagnosed with dacryops of the accessory lacrimal duct of the Wolfring gland. Although prior literature suggests that the risk of Wolfring dacryops may be associated with conjunctival scarring, this report presents a case of spontaneous Wolfring dacryops without history of ocular manipulation or inflammation. Small, asymptomatic cases of dacryops can be safely monitored with serial eye exams.
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