Table of Contents
Sites | Etiology | Clinical features | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Jain D. Granulomatous conjunctivitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyeconjgranulomatous.html. Accessed December 18th, 2024.
Sites
- Unilateral or bilateral (in systemic diseases)
- Palpebral conjunctiva and upper lid more often in tuberculosis
Etiology
- Usually associated with systemic disease
- Conjunctival granulomata form in response to foreign body, allergen, infectious organism or as part of systemic disease
- With necrosis:
- Tuberculosis (Int Ophthalmol 2014;34:655)
- Parinaud oculoglandular syndrome due to cat scratch fever (Ugeskr Laeger 1995;157:4137) or tularemia (Am J Ophthalmol 2001;131:283)
- Granulomatosis with polyangiitis (Wegener's) (Ophthalmology 2003;110:1770)
- Without necrosis:
- Crohn's disease (Br J Ophthalmol 1984;68:901)
- Foreign bodies (ophthalmia nodosa due to hair of caterpillar, surgical talc) (J AAPOS 2007;11:402)
- Hodgkin lymphoma (Am J Ophthalmol 2001;131:796)
- Sarcoidosis
- Syphilis
- Other:
- Acid fast bacilli
- Actinic granulomas (Ophthalmology 2013;120:1786)
- Churg-Strauss syndrome (Arch Ophthalmol 2012;130:1228)
- Drugs (brimonidine-timolol fixed combination) (Int Ophthalmol 2013;33:557, Br J Ophthalmol 2007;91:691)
- HIV (Ocul Immunol Inflamm 2006;14:309)
- Ocular rosacea in children
- Parasites (Ophthalmology 2001;108:1223)
- Ulcerative colitis (Eye (Lond) 2013;27:567)
Clinical features
- Eye discharge, watering, redness and itching
- Often regional lymphadenopathy
Case reports
- 2 and 5 year old girls with conjunctivitis due to synthetic fibers from teddy bears (BMC Ophthalmol 2011;11:17)
- 34 year old male cattle farmer with no history of trauma (Cornea 2002;21:831)
- 62 year old woman with bulbar conjunctival sporotrichosis presenting as tumor (Cornea 2010;29:573)
- Two women with Sporothrix schenckii (Cornea 2005;24:491)
Treatment
- Varies by etiology
- Tuberculosis: anti-tuberculosis therapy, topical prednisolone
- Excision in systemic conditions
Gross description
- Sarcoidosis: (EyeWiki: Conjunctival Biopsy in the Diagnosis of Ocular Sarcoidosis [Accessed 25 April 2018])
- Small, tan conjunctival nodules
- Tuberculosis: ulcerative, nodular, hypertrophic granulomatous and pedunculated
Microscopic (histologic) description
- Chronic inflammatory infiltrate with epitheloid histiocytes and giant cells
- Elastolysis and granulomatous inflammation in actinic granuloma