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2010 OMIG, Abstract 17

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New bugs and a new treatment for giant fornix syndrome 
J.B. Taylor,1 R.E. Fintelmann,1,2 E.Y. Tu,3 B.H Jeng1,2 
1Dept. of Ophthalmology and 2Francis I. Proctor Foundation, University of California San Francisco, CA, and 3Dept. of Ophthalmology University of Illinois Chicago, IL

Purpose: Giant fornix syndrome is classically described as a chronic, copiously purulent, Staphylococcus aureus conjunctivitis seen in elderly patients with dehiscence of the levator palpebrae superioris aponeurosis.  We report two cases of giant fornix syndrome, both of which were caused by an organism which was previously unreported in this condition, and both of which were treated with a novel intervention.
Methods: Case series.
Results: In both patients, in addition to Staphylococcus aureus, Pseudomonas aeruginosa was also found as a causative organism for the conjunctivitis.  In addition, after failing to respond to several months of aggressive treatment including both fortified topical and systemic antibiotics, both patients were treated with repeated sweepings of the conjunctival fornices with povidone-iodine on a cotton swab.  After this treatment course, one patient’s conjunctivitis resolved entirely, and the other patient’s improved significantly.
Conclusions: Giant fornix syndrome can be caused by infection with P. aeruginosa. In addition, in cases of giant fornix syndrome recalcitrant to standard therapies, sweeping of the conjunctival fornices with povidone-iodine may be a useful treatment modality.
Disclosure Code: N

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