Original articleThe giant fornix syndrome: An unrecognized cause of chronic, relapsing, grossly purulent conjunctivitis☆
Section snippets
Patients and methods
The clinical notes for patients referred, between 1991 and 2002, with recurrent episodes of gross purulent conjunctivitis and characterized by extremely severe inflammation of a large upper conjunctival fornix were reviewed retrospectively. Ethical committee approval was not required for this study.
Case 1
A frail 91-year-old woman presented with a 2-year history of recurrent episodes of left conjunctivitis, with copious amounts of creamy ocular discharge that gummed the eye closed. She had received multiple courses of topical antibiotic therapy and, 1 year before referral, had developed a spontaneous (nontraumatic) corneal perforation that healed on medical therapy.
The patient had hand movements vision in the affected eye at time of referral to Moorfields Eye Hospital, due to a central scar at
Discussion
These patients all presented with chronic, severe, copiously purulent pseudomembranous conjunctivitis with, in many cases, a serious disturbance of the ocular surface and corneal scarring secondary to the toxic environment. The corneal changes were variable: all patients displayed a severe punctate epithelial keratopathy, reversible in some cases (e.g., nos. 3 and 11) (Fig 1E) but leading to persistent dystrophic epithelium in others (nos. 7 and 9). Prolonged disease was associated with
Acknowledgements
The author thanks his colleagues, Mr John Dart and Mr Frank Larkin, for allowing him to report cases under his and their joint care at Moorfields Eye Hospital.
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Cited by (0)
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Manuscript no. 230326.
The author has no conflict of interest or financial interest in the subject presented.