Conjunctival rhinosporidiosis associated with scleral melting and staphyloma formation: Diagnosis and management

Purpose. Although conjunctival rhinosporidiosis is endemic in India, associ ated scleral melting and staphyloma formation are quite rare. We report cli nical features and management in three patients with this unusual presentat ion. Methods. Retrospective review of case records of three patients with c onjunctival rhinosporidiosis. Results. Infection occurred in young, healthy adults and was localized to the forniceal conjunctiva in all patients. The affected conjunctiva had numerous grey-white spherules, but a polyp-like l esion was not present in any patient. Diagnosis was based on clinical featu res and examination of scrapings from the involved conjunctiva. Treatment w as surgical, with excision of infected conjunctival tissues and staphyloma repair with homologous sclera or autogenous periosteum. Failure to recogniz e the conjunctival pathology in one patient resulted in recurrence of the s taphyloma. Conclusion. Conjunctival rhinosporidiosis can be associated with scleral staphyloma in young, healthy, adults. Differentiating this entity from idiopathic scleral ectasia requires knowledge of the clinical features of conjunctival rhinosporidiosis and a high index of clinical suspicion.