Probing for simple CNLDO in young children is adequate. Bicanalicular silastic intubation seems to have a role in achieving successful outcomes in complex CNLDO.

We present a rare case of infected pyogenic conjunctival granuloma mimicking a conjunctival abscess as complication of strabismus surgery in a Saudi girl with exotropia. Despite administration of local antibiotics following strabismus surgery, a patient presented with localised redness and discharge after three weeks. The patient was afebrile with no signs of pre-septal or orbital cellulitis. After culture (Staphylococcus aureus) sensitivity testing the patient was prescribed oral Amoxicillin and Clavulanate and reviewed under general anaesthesia. A 55 mm2 conjunctival pyogenic granuloma was noted. A punch biopsy specimen indicated inflammatory and histiocytic cells. The addition of steroid to the medical therapy resulted in a quiet eye after three weeks.