Ocular Sporotrichosis with Limbal Stem Cell Deficiency: An Impostor with Blinding Sequelae

Sporotrichosis is a chronic granulomatous fungal infection caused by Sporothrix schenckii. Inoculation of the fungus through breached skin or mucosa typically results in nodular ulceration of the cutaneous and subcutaneous tissue as well as its draining lymphatic nodules. However, reports on ocular involvement have recently increased. We describe a severe case of diffuse granulomatous conjunctivitis involving bulbar and palpebral conjunctiva, resulting in inevitable damage to the limbal stem cells. Isolation of S. schenckii from a conjunctival swab confirmed the diagnosis of sporotrichosis. A 6-month course of oral antifungal therapy was given through which the patient fully recovered. However, extensive corneal conjunctivalization secondary to total limbal stem cell deficiency has caused almost complete blindness in the affected eye. Clinical suspicion of this zoonotic disease is essential for early diagnosis and prompt treatment to prevent ocular surface complication and blindness.