A 69-year-old Caucasian female presents to the eye clinic with a complaint of a new itchy growth on her left lower eyelid. Over the previous two weeks the irritation caused by the lesion has become increasingly bothersome. The lesion appears as a pink growth within the nasal canthus. She has also been experiencing excessive tearing and purulent discharge of the left eye. The patient denies having similar lesions in the past. Warm compresses and artificial tears has not relieved any of her symptoms. On physical examination, a soft, non-tender, flesh-colored lesion is protruding from the patient's left lower puncta. The round lesion is entirely blocking the puncta (Figure 1 and Figure 2). It is vascularized with a smooth mucosal appearance. There is additional inflammation surrounding the lesion in the nasal region of the lower eyelid. There are no additional abnormalities to the lids, lashes, or conjunctiva of either eye.