Ocular rhinosporidiosis presenting as recurrent chalazion

Rhinosporidiosis, a granulomatous disease caused by Rhinosporidium seeberi, is widely prevalent in Sri Lanka and southern parts of India. Besides the eye, the lacrimal passage and nasal cavity are affected. The most common ocular involvement is a subconjunctival bleeding mass. Our case, a 9-year-old girl from a rural background with a history of pond water bathing, presented with a marginal chalazion involving the left lower lid. She had a history of chalazion involving the same site three months earlier which was managed by incision and curettage. A decision of surgical exploration was made and the evacuated mass was examined histologically showing evidence of rhinosporidiosis. This type of clinical presentation for ocular rhinosporidiosis (as recurrent chalazion) has not been reported earlier in the literature. This case emphasises that the clinicians from this part of the world must consider ocular rhinosporidiosis as differential diagnosis in cases with recurrent chalazion especially in a rural background with a habit of pond water bathing.