Recurrent bilateral eyelid and conjunctival granulomatosis in Churg-Strauss syndrome.

A 47-year-old woman with poorly controlled asthma and allergic rhinitis presented with recurrent episodes of bilateral upper eyelid swelling associated with forniceal conjunctival mass for the past 10 years. Routine blood investigations showed raised IgE levels and raised eosinophil counts. The diagnosis of Churg-Strauss syndrome (CSS) was made following biopsy of the conjunctival mass. The symptoms responded well to oral steroid treatment but recurred following cessation of the therapy. The patient was co-managed with a rheumatologist and the patient currently remains stable and is on oral Methotrexate and low dose oral steroids. Ocular involvement in CSS is unusual but this unique presentation of CSS was successfully managed, and the patient remains in remission.

Primary Conjunctiva Tuberculosis and Review of Literature.

The causes of chronic conjunctivitis are exhaustive, infection being the commonest. Primary tuberculosis(TB) involving the conjunctiva is rare. History of chronicity, worsening symptoms with steroids and clinical signs of subconjunctiva nodules could point towards the diagnosis of primary conjunctiva tuberculosis especially in endemic countries. Clinicopathological diagnosis is imperative to confirm this diagnosis. We report a case of a young lady who presented with a non-resolving chronic conjunctivitis that was proven to be TB and responded well to anti-tuberculosis treatment.