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Fung et al. Plast Aesthet Res 2020;7:55 Plastic and
DOI: 10.20517/2347-9264.2020.60 Aesthetic Research

Case Report Open Access

Wolfring dacryops: a case of acquired ptosis in a
child

Sammie E. Fung , Clara J. Men , Bobby S. Korn , Don O. Kikkawa , Catherine Y. Liu 2
2
1
2,3
2,3
1 University of California San Diego School of Medicine, La Jolla, CA 92037, USA.
2 Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department of Ophthalmology, La Jolla, CA 92037,
USA.
3 Divsion of Plastic Surgery, UC San Diego Department of Surgery, La Jolla, CA 92037, USA.
Correspondence to: Dr. Catherine Y. Liu, Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department
of Ophthalmology, La Jolla, CA 92037, USA. E-mail: yul107@health.ucsd.edu

How to cite this article: Fung SE, Men CJ, Korn BS, Kikkawa DO, Liu CY. Wolfring dacryops: a case of acquired ptosis in a child.
Plast Aesthet Res 2020;7:55. http://dx.doi.org/10.20517/2347-9264.2020.60

Received: 31 Mar 2020 First Decision: 2 Sep 2020 Revised: 9 Sep 2020 Accepted: 29 Sep 2020 Published: 21 Oct 2020
Academic Editor: Raúl González-García Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
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.

Keywords: Accessory gland, ductal cyst, lacrimal gland, Wolfring gland, dacryops

INTRODUCTION
Blepharoptosis (or ptosis) is a common presenting complaint in the oculoplastics clinic and can be found
amongst all age groups. In the adult population, acquired aponeurotic ptosis is the most common type,
[1]
making up about 60% of cases in one study . In children, congenital ptosis, a type of myogenic ptosis,

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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