Conjunctival Rhinosporidiosis with Lateral Rectus Muscle Involvement

85 Dear Editor, We report a case of a 69‐year‐old man with right eye conjunctival rhinosporidiosis involving the lateral rectus muscle. The patient presented with a progressive swelling of the temporal conjunctiva of the right eye and intermittent binocular diplopia for four months. There was no history of diminished vision, epiphora, and photophobia. The patient was a swimmer. The best‐corrected visual acuity was 20/60 in both eyes. Slit lamp examination of the right eye showed a red, elevated, non‐ulcerated vascular mass arising from the lateral aspect of the bulbar conjunctiva 12 mm from the temporal limbus [Figure 1]. The biomicroscopic examination was otherwise normal. Ocular motility, intraocular pressure, and dilated fundus examinations were not remarkable in both eyes. The lesion was excised with surrounding 5 mm of conjunctiva under topical 0.5% proparacaine hydrochloride drops. The base of the lesion was attached to the lateral rectus muscle sheath. The excision area was treated with 5% povidone‐iodine. Histopathological examination of the lesion showed multiple sporangia in the subepithelial area consistent with rhinosporidiosis [Figure 2]. The present case had the typical appearance of conjunctival rhinosporidiosis, which was confirmed by histopathological examination of the excised lesion. Recurrence has been noted after successful excision, and medical therapy is considered controversial since the culture of the organism has not been successful in artificial media, making sensitivity determination impossible.[1] However, oral dapsone is recommended to prevent recurrence after excision of the lesion.[2] The most effective treatment is surgical excision with Conjunctival Rhinosporidiosis with Lateral Rectus Muscle Involvement