A Case of Verruca Obliterating the Punctum

Purpose: To report a case of verruca vulgaris appeared over punctum without involving conjunctival lesion. Case summary: A 36-year-old woman presented with tearing of her left eye. On slit lamp examination, about 5mm-sized round papilloma inside of the punctum of the left lower eyelid was observed. The mass was obstructing the entire punctum. Excisional biopsy was performed with snip punctoplasty. In pathology exam, koilocytes were observed. Polymerase chain reaction (PCR) test showed the positive result of HPV types 6 and 11. Conclusions: Verruca vulgaris could appears in the punctum and nasolacrimal drainage system without any conjunctival lesion.