Clinical Spectrum and Management Outcome of Ocular and Adnexal Rhinosporidiosis

PURPOSE: To describe the clinical spectrum and management outcomes of ocular rhinosporidiosis. METHODS: All histopathologically diagnosed cases of ocular rhinosporidiosis between January 2000 and December 2016 were included in the study. The lesions were classified based on the site of involvement, namely conjunctiva, lacrimal sac, eyelid, and orbit. The frequency and percentages for each of the lesions and the different treatment modalities were noted and calculated. Any recurrence and its subsequent management were also noted. RESULTS: A total of 34 patients were included with a male-to-female ratio of 2.7:1. Conjunctiva was the most common site involved (19, 55.8%), followed by lacrimal sac (11, 32.3%) and eyelid (3, 8.82%). One patient had orbital involvement secondary to sinonasal extension. The mean duration of symptoms was 14.8 ± 19.1 months (range, 1–84 months). Seven (36.8%) patients in the conjunctival group needed scleral patch graft. Five patients (45.4%) with lacrimal sac rhinosporidiosis underwent dacryocystectomy and modified dacryocystorhinostomy (DCR). The mean follow-up period was 5.43 ± 7.9 months (range, 1–36 months). Five (14.7%) patients (2 conjunctival, 2 lacrimal, and 1 eyelid) had recurrence. CONCLUSIONS: Conjunctiva is the most common site for ocular rhinosporidiosis, followed by lacrimal sac. While conjunctival lesions respond well to complete excision with cauterization of the base, lacrimal sac lesions can be managed by a modified DCR. Eyelid rhinosporidiosis can mimic a neoplasm and should be considered in differential diagnosis in suspicious lesions, especially in endemic areas.