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Bilateral, chronic, bacterial conjunctivitis in giant fornix syndrome
  1. Patrick Commiskey,
  2. Eve Bowers,
  3. Aidan Dmitriev and
  4. Alex Mammen
  1. Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Patrick Commiskey; patrick.commiskey{at}


Giant fornix syndrome (GFS) results in chronic, relapsing conjunctivitis in elderly patients with enophthalmos and enlarged fornices, in which infectious material collects and perpetuates inflammation. A 98-year-old woman presented with persistent, bilateral, purulent conjunctivitis; corneal epithelial defects and progressive blepharospasm that did not respond to artificial tears, topical antibiotics and steroids and amniotic membrane grafts. Additional findings of deep-set orbits with enlarged upper fornices were diagnostic of GFS. Over the next 2 months, she responded to a combination of topical and systemic antibiotics, autologous serum eye drops, povidone-iodine forniceal rinses, and hypochlorous acid treatment of the eyelashes. GFS is an important diagnostic consideration in elderly patients with chronic conjunctivitis and deep-set orbits.

  • ophthalmology
  • anterior chamber

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  • Contributors Concept and design: PC and AM. Data collection: PC and EB. Analysis and interpretation; writing the article; critical revision of the article and final approval of the article: PC, EB, AD and AM.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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