Purpose: To report a case of epiphora due to megalocaruncle treated by partial resection of the enlargement lacrimal caruncle.

Case summary: A 62- year- old male, with no specific diseases, presented to our clinic with epiphora in both eyes that started 5 years ago. In the slit lamp examination there were no abnormal findings other than hypertrophic lacrimal caruncles in both eyes. Although there were no abnormal findings in the lacrimal probe exam, irrigation test and dacryocystography, residual dye was observed in the Fluorescein Dye Disappearance Test using 2% fluorescein. The patient was then diagnosed with functional obstruction due to hypertrophic lacrimal caruncles. The symptoms improved after partial resection of the lacrimal caruncles. The biopsy using the resected tissue showed mild intraepithelial dysplasia and further observation was decided.

Conclusions: A hypertrophic caruncle can be the cause of epiphora, and the hypertrophic tissue should be biopsied in order to exclude the possibility of neoplasms.