Allergic Conjunctival Granuloma Presenting the Splendore-Hoeppli Phenomenon; Report of Two Cases and Review of Literature

To report two cases of bilateral conjunctival granuloma with histopathological features of the Splendore-Hoeppli phenomenon and review of the literature. Two female patients, one with a history of pulmonary eosinophilic infiltration and another with a history of vernal keratoconjunctivitis, presented with bilateral cream to yellow colored nodules in the superior bulbar conjunctiva. Histopathologic examination revealed characteristic features of the Splendore-Hoeppli phenomenon manifesting as zones of amorphous eosinophilic material surrounded by aggregations of epithelioid histiocytes, giant cells, eosinophils and lymphoplasmacytic infiltrates. No evidence of infectious organisms was found. Our report adds to non-infectious cases of conjunctival Splendore-Hoeppli phenomenon. Previous history of allergic disorders may have contributed to the occurrence of this entity.