Unilateral Epiphora Caused by a Papilloma of the Lower Canaliculus

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Abstract
WHEN a patient presents with unilateral epiphora associated with a distended canaliculus, the usual finding is canaliculitis caused by Actinomyces israeli (formerly known as Streptothrix foersteri) in which there is a soft concretion in a diverticulum of the canaliculus or distending the canaliculus itself. Additional causes are found at times, as in the case reported Report of a Case A 62-year-old man, bothered by watering of the left eye, sought medical attention three weeks after he first noticed a growth protruding from the left lower punctum. There was swelling of the eyelid in the region of the left lower canaliculus, and a small mass protruded through the punctum (Fig 1). The exposed part of the mass was excised for diagnostic examinations. Cultures and smears of the biopsy failed to demonstrate organisms. The Giemsa stain showed only epithelial cells without inflammatory cells. Microscopic sections showed that this initial biopsy consisted only

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