The lacrimal caruncle is the small, pink, fleshy bump located in the inner corner of the eye, next to the tear duct opening. Swelling in this prominent area can be unsettling, but it frequently indicates a minor, localized issue that is easily treated. Understanding the caruncle’s structure helps clarify why it reacts to certain irritations or infections.
Understanding the Lacrimal Caruncle
The lacrimal caruncle is unique because it contains elements typically found on the skin, such as sebaceous glands, sweat glands, and fine hair follicles. These specialized glands secrete oil and mucus that contribute to the stability of the tear film. The caruncle also acts as a collection point for small debris and older tear components before they enter the tear drainage system.
Acute and Common Causes of Swelling
The most frequent reasons for caruncle swelling are acute processes like localized infections, allergic reactions, or mechanical irritation. Because the caruncle contains sebaceous glands, it is susceptible to blockages that can lead to a localized infection, similar to a stye or pimple. When a gland becomes clogged, it traps bacteria, resulting in a tender, reddened, and painful nodule. This infectious swelling is often accompanied by a thick, yellowish, or pus-filled discharge.
Infections involving the adjacent tear drainage system, such as dacryocystitis, can also cause swelling that extends to the caruncle area. Dacryocystitis is an inflammation of the lacrimal sac, which sits beneath the inner corner of the eye. This condition typically causes sudden, pronounced swelling with significant tenderness and pain, and the caruncle can become inflamed as the infection spreads.
Allergic conjunctivitis is another common cause, producing symptoms different from an infection. An allergic reaction, often triggered by pollen, dust, or pet dander, causes the release of histamine in the eye tissue. This leads to blood vessel dilation and fluid accumulation, resulting in a swollen, intensely itchy caruncle and surrounding conjunctiva. Unlike an infection, allergic swelling presents with a watery, clear discharge and a distinct sensation of itching.
Direct mechanical trauma can also induce rapid swelling. Excessive eye rubbing, especially in response to irritation from a foreign body or contact lens overuse, can traumatize the delicate tissue. The constant friction causes inflammation, leading to temporary swelling and redness in the caruncle area. This type of swelling typically subsides quickly once the source of irritation is removed.
Less Frequent and Chronic Diagnoses
Persistent or slowly developing caruncle swelling may be attributed to chronic inflammatory conditions or structural changes. Chronic blepharitis, an ongoing inflammation of the eyelid margins, can involve the caruncle and cause long-term irritation and mild thickening. This condition is often associated with scaling or crusting at the base of the eyelashes and can lead to recurrent, low-grade inflammation of the caruncle’s glands.
A variety of benign growths also appear in this area due to the caruncle’s unique composition. The most frequently observed benign lesions are nevi (moles) and papillomas (small, wart-like growths) that may cause a bumpy, irregular appearance. Other benign structural issues include retention cysts, which form when sebaceous or sweat glands become blocked without acute infection. These growths are typically slow-growing, painless, and represent a structural change.
In rare instances, chronic or progressive swelling may signal a malignant lesion, such as a carcinoma or melanoma. These are uncommon, comprising a small percentage of all caruncle lesions, and are more frequently seen in older individuals. A growth that is rapidly changing in size, color, or shape, or one that bleeds easily, raises suspicion. A definitive diagnosis for any persistent or suspicious mass relies on a tissue biopsy.
When to Seek Professional Medical Care
While many cases of caruncle swelling resolve with simple home care, certain signs indicate the necessity of prompt professional medical evaluation. Any swelling accompanied by a sudden loss or change in vision, such as double vision or blurriness, requires immediate attention. Severe, unrelenting pain, especially if it extends beyond the eye area to the head or face, should also be evaluated without delay.
Other warning signs include swelling that spreads rapidly to the eyelid or surrounding facial tissue, or the presence of a fever or profound malaise. These symptoms can suggest a more widespread infection. If the swelling does not begin to improve within 48 to 72 hours of initial home management, a consultation is warranted. A medical professional can use specialized tools, like a slit lamp microscope, to examine the caruncle and determine the specific cause.
For acute infectious swelling, initial home care involves gently applying a clean, warm compress to the area for five to ten minutes, multiple times a day, to encourage drainage. Avoid rubbing the eye or attempting to squeeze the swelling, as this can worsen inflammation or push the infection deeper. Discontinuing the use of contact lenses and eye makeup until the swelling resolves also helps prevent further irritation and contamination.