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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Management of giant fornix syndrome with irrigation with povidone-iodine
  1. Rushmia Karim,
  2. Niraj Mandal,
  3. Steve Tuft
  1. Cornea and External Diseases Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Niraj Mandal, nirajmandal{at}doctors.org.uk

Summary

Giant fornix syndrome (GFS) was first described as a cause for a relapsing mucopurulent conjunctivitis. Predominantly elderly patients have enlarged superior fornices from superior aponeurosis dehiscence that permits the accumulation of protein coagulum that is colonised by bacteria. Established treatment includes the use of intensive topical antibiotic and corticosteroid. We describe a case of a 98-year-old woman with GFS who did not respond to several weeks of intensive (two hourly) treatment with topical prednisolone 1% drops and chloramphenicol. Subsequent additional regular sweeping of the fornices with cotton buds and topical medication did not improve her symptoms but which resolved with manual coagulum debridement and application of 10% povidone-iodine. This treatment offers an effective treatment option of GFS cases, which do not respond to intensive topical corticosteroids and chloramphenicol.

  • ophthalmology
  • eye

https://doi.org/10.1136/bcr-2018-225555

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    Footnotes

    • Contributors RK: involved in the direct clinical care of the patient and acquisition of clinical details for the case report. NM: involved in planning and the reporting of this case report and obtaining clinical photographs. ST: lead consultant who was in charge of the overall surgical and medical management of the patient and was involved in reporting the case.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.