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Jackson Lever, Emily Eubanks, Chirag Gupta, Anne Barmettler, Juan Javier Servat, Francesca Nesi-Eloff; Giant fornix syndrome with chronic methicillin resistant staphylococcus aureus conjunctivitis causing nasal lacrimal duct obstruction. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5348.
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To report the association of giant fornix, chronic methicillin resistant staph aureus (MRSA) conjunctivitis and nasal lacrimal duct obstruction (NLDO).
Case series of patients referred to an oculoplastics office with the diagnosis of epiphoria. Each patient underwent evaluation for epiphoria that included probing and irrigation of the upper and lower canaliculi with assessment of reflux and discharge. Abnormality or malposition of lids and punctum were also noted. Patients found with NLDO underwent surgical management and post-operative symptoms were monitored.
Three patients referred for epiphoria were found to have giant fornix syndrome. All three patients had conjunctival cultures positive for MRSA. Two underwent dacryocystorhinostomy (DCR). Despite successful anatomical DCR, the patients continued to have complicated post-operative courses. One patient underwent dacryocystectomy.
Chronic MRSA conjunctivitis secondary to giant fornix syndrome can contribue to NLDO. Despite anatomically successful DCR, symptoms may persist sans addressing the giant fornix. Giant fornix syndrome should be included in the differential while evaluating patient for epiphoria.
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