Wolfring Dacryops: A Case Report

Purpose: We present a case of dacryops originating from the Wolfring accessory lacrimal gland. Case summary: A 37-year-old woman was referred to our Ophthalmology Department following the incidental detection of a cystic mass in the left orbit on magnetic resonance imaging performed for chronic migraine evaluation. Although the patient reported no ocular symptoms, a mild lid lag was observed in the affected eye. Palpation revealed a soft, non-tender mass localized to the upper medial orbit. Contrast-enhanced computed tomography of the orbit demonstrated a well-circumscribed, non-enhancing 1.6-cm cystic lesion. A diagnosis of a lacrimal ductal cyst originating from the Wolfring accessory lacrimal gland was established. Conservative management with two percutaneous aspirations at 6-month intervals resulted in recurrence. Subsequent marsupialization of the cyst via a conjunctival approach under local anesthesia was performed. Histopathological examination confirmed the diagnosis of a unilocular cyst lined by simple cuboidal epithelium. At 1.5 months of postoperative follow-up, the patient remained asymptomatic with no evidence of recurrence. Conclusions: We present a case of Wolfring dacryops in a patient with chronic migraine, a rare condition that can be effectively managed with straightforward surgical intervention. These findings underscore the critical importance of accurate diagnosis and targeted treatment.