Conjunctival Granuloma Research Articles

A long-standing vegetative foreign body and delayed granuloma response

Any foreign body (FB) insult to the eye may lead to varied ophthalmic manifestations. A long-standing FB in the conjunctiva/fornices can trigger a chronic inflammatory reaction, leading to granuloma formation. Patients generally present early with specific history, FB sensations, watering, redness, or epibulbar swelling. Specific history and careful examinations lead to early diagnosis and definitive treatment. Any long-standing epibulbar swelling should raise the suspicion of FB granuloma. Herein, we report a case of delayed-onset conjunctival granuloma response secondary to a long-standing vegetative FB, which is a rare occurrence.

Ocular filariasis in the form of a conjunctival granuloma – A rare case report from non-endemic part of India

Filariasis, a predominantly lymphatic disease can rarely have ocular involvement in endemic as well as a few non-endemic zones of the Indian subcontinent. It has also been reported from countries of South East Asia. In India, Wuchereria bancrofti and Brugia malayi are the nematodes causing filariais. Ocular involvement can happen in a wide spectrum, involving lacrimal glands, conjunctiva and fornices, cornea, anterior chamber, and vitreous cavity. We report a case of adult filarial worm (B. malayi) inside a conjunctival granuloma in a lady hailing from a rural, non-endemic part of the country. The lady presented with a short history of ocular irritation and redness. Clinical examination revealed a small granuloma-like lesion with surrounding inflammation over the conjunctiva. The rest of the anterior segment as well as the posterior segment was fairly within normal limits. The history as well as clinical examination was not supportive of a parasitic infestation, leading the doctors to treat the lesion as an allergic disease. However, the lesion remained unresolved, and surgical excision was undertaken. On surgical intervention, a live worm was spotted inside the lesion. Parasitological evaluation of the worm was confirmatory of adult filaria (B. malayi). The patient responded to a combination therapy of oral diethylcarbamazine and albendazole.

‘Y’ Modification of the cutaneous incision of the preseptal transconjunctival approach for the management of zygomatico-maxillary complex fractures: A prospective clinical study

AimThe purpose of this clinical study was to evaluate the efficacy of the preseptal transconjunctival approach with Y modification of the cutaneous extension for the management of zygomaticomaxillary complex (ZMC) fractures. MethodsThis prospective interventional study was conducted at our institute from 2012 to 2020. The study included patients aged 15–65 years with displaced ZMC fractures. Patients with uncontrolled systemic conditions, infected and/or comminuted fractures were excluded. The variables evaluated were age, gender, mechanism of injury, fracture side, clinical features, surgical exposure time, adequacy of exposure, complications, scar evaluation scores and cosmetic outcomes. The parameters for comparison were operated versus non operated side Eye Fissure Index (EFI) and surgical exposure time was compared with respect to the types of scars. ResultsA total of 49 patients were included in this study. The average exposure time was 18.87 ± 1.92 min. The exposure of fracture site was excellent in 73.5 % and satisfactory in 26.5 %. The mean EFI of operated side was 34.2 ± 5.04 mm while that of non-operated side was 34.22 ± 5 mm. On comparison of the same there was no significant difference. Invisible scars were noted in 71.4 % and barely visible scars in 22.4 %. The comparison of exposure time with type of scars showed a significant association (p = 0.02). The complications noted were chemosis, lower eyelid edema, conjunctival granuloma and entropion. Cosmetic outcomes were fairly satisfactory. ConclusionThe Y modification of the transconjunctival approach can provide excellent surgical exposure without the need for a second incision. Although this approach is technique sensitive and requires experience, the advantages outweigh the learning curve. Since this approach has been widely studied, a systematized review is recommended to further substantiate its reliability and advantages.

A rare case of conjunctival granuloma in Aurolab aqueous drainage implant (AADI) with supramid

Conjunctival granuloma (CG) can be caused by a foreign body, surgically related inflammation, an allergen, an infectious organism, or as part of a systemic disease. We are reporting the first case of CG related to 5-0 prolene as supramid, which is used as an intraluminal stent in AADI to prevent hypotony. A 70-year-old female diagnosed with POAG in both eyes with posterior PCIOL on MMT with advanced disc damage and uncontrolled IOP in the right eye underwent AADI with supramid. The patient developed mild irritation and redness in RE in the fourth month of follow-up. On slit-lamp examination, there was localized CG at the end of the supramid tip. CG resolved with the removal of the supramid suture and medical treatment. Supramid-related CG is rare and generally causes non-fatal material-related hypersensitivity reactions that can be treated well with medications and removal of inciting factors.

Conjunctival pyogenic granuloma: A series of three case reports

Conjunctival pyogenic granuloma (PG) is an acquired, benign lobulated capillary hemangioma. The etiology of PG is not known properly. It is most commonly seen at a traumatic wound site or near a suture line after surgery and other insults. Herein, we report three cases of conjunctival PG and found a relationship with post-dental treatment in two of our cases.

Bilateral Conjunctival Actinic Granuloma With Necrobiotic Vasculitic Pattern: A Diagnosis of Exclusion.

A 53-year-old Caucasian male presented with an inflamed-appearing limbal nodule in his OD, clinically compatible with nodular episcleritis, that was unresponsive to topical corticosteroid therapy. Excisional biopsy of the lesion was performed and histopathological examination revealed foci of necrotizing vasculitis and granulomatous inflammation in a background of intense actinic elastosis. Infectious stains for organisms were negative. A comprehensive systemic evaluation for vasculitides was negative. Three years later, the patient returned with a clinically and histopathologically identical lesion in his OS. Systemic evaluation was noncontributory again, and a diagnosis of bilateral conjunctival actinic granuloma with necrobiotic vasculitic pattern was made.

Conjunctival Foreign Body Granuloma after Pterygium Excision and Adaptation by Polyglactin Sutures

Abbreviations OD: oculus dexter (right eye) OS: oculus sinister (left eye) OU: oculus uterque (both eyes)

MEDICAL MANAGEMENT OF OCULAR SARCOIDOSIS

Sarcoidosis is one of the leading causes of inflammatory eye disease. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues, and may cause uveitis, episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Glaucoma and cataract can be complications from inflammation itself or adverse effects from therapy. Ophthalmic manifestations can be isolated, or associated with other organ involvement. Patients with ocular sarcoidosis can present with a wide range of clinical presentations and severity. Multi-disciplinary approaches are required to achieve the best treatment outcomes for both ocular and systemic manifestations.

Ocular tuberculosis presenting with a conjunctival granuloma

An 18-year-old female patient was referred with complaints of tearing and redness in the left eye for 3 months after a mild ocular trauma with a turkey feather. She was treated with topical antibiotics and corticosteroids with no improvement. Slit-lamp examination of the left eye showed a vascularized lesion with a polypoidal appearance due to multiple contiguous micronodules on the temporal and inferior bulbar conjunctiva. Results of the anterior and posterior segment examination were unremarkable in both eyes. A biopsy specimen of the conjunctival mass showed multiple tuberculoid granulomas composed of epithelioid histiocytes with associated Langhan's type multinucleate giant cells and a necrotic nodule surrounded by histiocytes and giant cells. The Mantoux test was positive with induration of 15mm. The patient was prescribed antituberculosis therapy. Three months after treatment initiation, the conjunctival lesions had resolved. Mycobacterium tuberculosis should be considered in cases of unilateral chronic recalcitrant conjunctivitis. Biopsy of a conjunctival mass is of utmost importance to establish a definite diagnosis.

Recurrence of conjunctival exuberant granulation tissue in a pony

SummaryA 22‐year‐old pony mare was presented at the Equine Hospital of the Faculty of Veterinary Medicine with a pedunculated exuberant granulation tissue (EGT) located at the lateral bulbar conjunctiva of the right eye. The granulation tissue, diagnosed by histology, grew over three and a half weeks after a superior and inferior Gundersen inlay flap procedure. The pony's underlying ocular pathology was diffuse corneal oedema, suspected to be related to immune‐mediated keratitis affecting the endothelium. Despite several surgical resections, topical corticosteroid treatment, intralesional injection of methylprednisolone acetate and electrosurgical cauterisation, the combination of a ligature at the peduncle base of the mass, intralesional injection of methylprednisolone acetate and removal of the facemask seemed to be the most efficient treatment. The mass did not recur after 33 months of follow‐up. Similar healing tissue has been reported, secondary to surgical ophthalmic procedures in human medicine, in which it is called a conjunctival pyogenic granuloma (CPG).

Polyester 5–0 suture for porous implant placement after retinoblastoma enucleation: analysis of 120 sockets

BackgroundTechniques used to suture the rectus muscle to the implant can influence the implant-related complications which is still a major problem following retinoblastoma enucleation. The goals of this work were to report the efficacy among patients with retinoblastoma who underwent enucleation followed by porous implant placement with the rectus muscles sutured with 5–0 polyester suture.MethodsThis was a retrospective study of consecutive patients with retinoblastoma who underwent primary enucleation and porous implant placement with the rectus muscles tagged and sutured to the implant with polyester 5–0 suture. All the patients were followed up for a minimum of 2 years. The main outcome measure was implant exposure. The secondary efficacy measures were other implant-related complications.ResultsBetween May 2016 and December 2018, a total of 120 patients (120 eyes) underwent primary enucleation and porous implant placement were included. Postoperatively, 10/120 (8.3%) eyes developed exposure or conjunctival granuloma. Exposure was the most common postoperative complication (7/10, 70.0%). There were no cases of implant extrusion, migration, or infection.ConclusionsPolyester 5–0 sutures are successful in patients with retinoblastoma who underwent enucleation followed by porous implant placement. Complications are minimal. Polyester 5–0 sutures were not associated with unacceptable complications in this pediatric population.

SURGICAL OUTCOME OF CONJUNCTIVALAUTOGRAFT USING AUTOLOGOUS BLOOD IN PATIENTS UNDERGOING PTERYGIUM SURGERY AT A TERTIARY CARE CENTRE IN KASHMIR

Background: Pterygium refers to a wing shaped brovascular growth of subconjunctival tissue that encroaches onto the cornea. Main modality of treatment of pterygium is surgical. Aim: To determine the surgical outcome of conjunctival autograft xation using autologous blood in patients attending OPD of Department of Ophthalmology, Government Medical College, Srinagar. Methods: This was a prospective interventional study conducted on 60 patients with primary pterygium attending the Department of Ophthalmology of a tertiary care centre in Kashmir over a period of 2 years from June 2019 to June 2021. Patients with recurrent pterygium, past history of ocular trauma and patients with bleeding diathesis were excluded from the study. Proper history was taken from all the patients and a detailed ophthalmological examination was done which included uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), IOP measurement. Detailed anterior segment and posterior segment examination was done. Results: Our study indicated mean age of patients as 55±3 years. There were 40 female patients (66.7%) and 20 male patients (33.3%). Majority of patients presented with grade-2 and grade-3 pterygium accounting for 50% and 25% cases respectively. Postoperative complications such as subconjunctival haemorrhage, graft edema, graft retraction and corneal epithelial defect were seen in 10%, 55%, 5% and 50% cases respectively. Graft loss and conjunctival granuloma were not seen in any of the patients in our study. Overall surgical outcome was good in our study patients with no postoperative complications at the end of 6 weeks follow-up. Conclusion: Our study concluded that majority of the patients who underwent pterygium excision with graft xation using autologous blood were females with grade-2 and grade-3 pterygium. Surgical outcome using autologous blood as a bioadhesive is a useful and good alternative to xation of conjunctival autograft using sutures or brin glue.

Sutureless and Glue Free Conjunctival Autograft in Pterygium Surgery

Objective: The objective of the study is to report a newer technique of pterygium excision followed by suture less and glue free conjunctival autograft for its complications and recurrence rate. 
 METHODS: This prospective and quassi experimental study was carried out at Baqai medical university hospital, Karachi from January 2016 to December 2016. This study consists of 30 eyes of 22 patients, above 15 years of age with primary progressive Pterygium of 2 mm or more in size and interfering with the vision. All the patients were operated under sub tenon’s anesthesia, Pterygium was excised with surgical blade followed by suture less and glue free conjunctival autograft from superior limbus. Primary outcomes measures included graft loss, granuloma and any other complications noted within six months. Recurrence was also noted at 6 months.
 RESULTS: There were 30 eyes of 22 patients. There were 4 females (18.18%) and 18 male patients (81.81%). The mean age was 31.28 years ± 9.4 SD. Right eye was seen in 16 (53%) cases. Graft lost was recorded in 1 patient (4.5%), conjunctival pyogenic granuloma in 1 patient (4.5%) and graft retraction was seen in 1 (4.5%) case. Recurrence rate was none at 6 months post operatively.
 CONCLUSION: Conjunctival autograft without suture and glue is a new and simple technique that can be done with minimal expenses and limited resources. It has fewer complications and no recurrence.

Recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient: a case report

BackgroundLigneous conjunctivitis is a rare form of chronic pseudomembranous conjunctivitis which usually starts during infancy. We report on an unsual case of recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient.MethodsThe equipment used for the slit-lamp images was a Haag Streit slit lamp BX900 Sn 00,406 with 16 × magnifications. The used batch number of the camera was sn00406 and the software was from the company CCS Pawlowski Merge Eye. There were no filters used. The images were saved with a resolution of 300 DPI. Neither downstream nor averaging was used to enhance the resolution of the image in the case presentation section or the figure legend.The equipment used for the cross-sectional histologic images was a Zeiss Axioskop 40 microscope with an objective lens Zeiss A-Plan × 20/0.45 (Zoom 6.3 × TV 2/3″″C). The used camera was AxioCam MRc5 and the software was ZEN 3.2. The cross-sectional histologic images were saved with a resolution of 2584 × 1936 Pixels. Neither downstream nor averaging was used to enhance the resolution of the image in the case presentation section or the figure legend.Case presentationThis is a rare case report of ligneous conjunctivitis in a 67-year-old male patient who presented a recurrent conjunctival granuloma after five excisions following cataract surgery in his left eye. We performed a tumor excision with free conjunctival autograft. The histology showed a fibrin crust including macrophages, granulocytes, lymphocytes, and reactively altered squamous cell nests. These findings were consistent with a ″pseudomembrane in conjunctivitis lignosa″. We administered a topical combination of plasminactivator, heparin, cortisone and cyclosporine.ConclusionThis treatment with the combination of plasminactivator, heparin, cortisone and cyclosporine has proven to be effective in preventing the recurrence of ligneous conjunctivitis.

A case series of ocular involvement in bullous pemphigoid: clinical features, management, and outcomes

Ocular involvement in cases of bullous pemphigoid is rare and when present, the signs are usually subtle and in the form of fine tarsal scarring and dry eye disease. The current report aims to describe the clinical features and management protocols in a series of cases with aggressive ocular manifestations at presentation. All cases of bullous pemphigoid seen between 2017 and 2020 were included in this retrospective case series. Data regarding the clinical features, treatment administered, and outcomes was collected. Five cases (n=10 eyes) of bullous pemphigoid disease with ocular involvement were included. All eyes had significant cicatricial conjunctival changes in the form of symblephara, inferior forniceal shortening, and tarsal conjunctival scarring. Conjunctival granulomas were present in 3/10 eyes. Corneal involvement in the form of punctate keratitis was present in all eyes while 4/10 eyes had an epithelial defect as well. The management of these cases involved topical therapy with corticosteroids and lubricants (n=10 eyes) while pulse doses of intravenous methyl prednisolone were administered in 5/5 cases. Pulse intravenous cyclophosphamide was supplemented in 2/5 cases. Adequate control of the disease was noted in 3/5 cases while one case had a recalcitrant form of the disease and developed a dermalised ocular surface in both eyes. The last patient was lost to follow up during the course of therapy. Bullous pemphigoid can present with an aggressive form of cicatrizing conjunctivitis similar to other variants of autoimmune blistering disorders and must be considered as a differential in cases presenting with ocular cicatricial disease. Long-term intensive immunosuppression is required for the management of these cases to preserve the visual function and the integrity of the globe.

Synthetic Fiber Granuloma Misdiagnosed as Chalazion in an 8-year-old Child

Purpose: We report a case of conjunctival synthetic fiber granuloma, which was misdiagnosed as chalazion. Case summary: An 8-year-old female patient, without any previous medical illness or ocular trauma history, visited our hospital with a prolonged mass-like lesion in the left lower palpebral conjunctiva. In her detailed medical history, she said that she often played with her doll's hair. The conjunctival mass first occurred 1 week before her visit to the private clinic. At that time, eye drop treatment was initiated under the diagnosis of chalazion. The child showed no improvement; thus, incision and curettage were performed. The mass in the conjunctiva continued to persist, so she was transferred to the hospital for a biopsy. Slit-lamp examination revealed a patterned agglomeration of fiber strands inside the mass. Complete excisional biopsy was performed under general anesthesia. Histopathological examination revealed a fibrous foreign body in the birefringence, with granulomatous inflammation surrounding it. The patient was diagnosed with synthetic fiber granuloma. Conclusions: Conjunctival synthetic fiber granulomas are easily mistaken as chalazion. If specific fibrous strands are entangled inside the mass on slit-lamp examination, diagnosis and treatment through therapeutic excisional biopsy are required under clinical suspicion.

A Case of Unilateral Choroidal Granuloma as a Sole Presentation of Sarcoidosis

<strong>Introduction:</strong> Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. It is one of the leading causes of inflammatory eye disease. The most common ocular manifestations are uveitis and conjunctival involvement. However, it can involve any part of the eye and its adnexal tissues and cause episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Rarely, it can present as bilateral choroidal granuloma. However, choroidal granuloma without other signs of intraocular inflammation and/or systemic involvement is an extremely rare manifestation. <strong>Case Description:</strong> A 38-year-old African American woman came to the ophthalmology service with the primary complaint of decreased visual acuity in her right eye and right eye pain. Upon examination, a serous macular detachment secondary to central serous retinopathy and a solitary choroidal granuloma were observed. On physical examination, she had eyelid enlargement and facial papules. Laboratory findings showed elevated ACE, while ANA, ANCA, Lyme, Syphilis, anti-dsDNA, QuantiFERON, RF, IL-2 R and lysozyme were all negative. A CT of the chest showed only mildly increased mediastinal lymph nodes in the right paratracheal region. Ophthalmology, rheumatology, and pulmonary teams were involved in further management. Treatment was started with daily oral prednisone and consequent addition of methotrexate which eventually resulted in reduced size of granuloma, resolution of the eye pain and improvement in vision. <strong>Discussion:</strong> There is no single way to diagnose sarcoidosis. Primary occurrence is, most often, between 20 and 40 years of age, with women being diagnosed more frequently than men. The disease is 10 to 17 times more common in African Americans than in Caucasians. The main diagnostic tools include Chest X-rays and high-resolution CT scan to look for pulmonary infiltrates or lymphadenopathy. Some patients with sarcoidosis may have elevated serum calcium levels, angiotensin converting enzyme (ACE) and/or lysozyme. The gold standard for the diagnosis is a tissue biopsy. However, suspected lesions may not be easily accessible, as in this case where only the eye was affected. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues. A solitary choroidal granuloma is one of the manifestations recognized in sarcoidosis, though the much more common manifestation is bilateral uveitis (reported in 30–70% of cases) and conjunctival nodules (found in 40% of cases). Ophthalmic manifestations can be isolated but most patients have evidence of systemic involvement at the time of the initial examination and have bilateral ocular presentation, unlike this patient who had solitary, unilateral choroidal granuloma without other signs of intraocular inflammation and systemic involvement. <strong>Conclusion:</strong> There are several cases of sarcoidosis reporting choroidal granuloma with either other ocular involvements and/or associated hilar lymphadenopathy and other systemic manifestations. This patient is a rare case where the sole presentation of sarcoidosis is a unilateral solitary granuloma. Biopsy was not feasible due to location of the lesion. This case shows the importance of a multi-disciplinary approach in rare cases where the gold standard for diagnosis is not possible.

Actinic Granuloma of the Conjunctiva: Case Series and Review of the Literature

To characterize the clinical and histopathologic features of actinic granuloma of the conjunctiva. Retrospective observational case series METHODS: Institutional pathology records between 2014 and 2020 were searched for all cases of conjunctival actinic granuloma. Information collected included age, sex, ocular and medical history, clinical findings, laboratory workup, treatment, follow-up, pathologic diagnosis, and histopathologic inflammation pattern. Eight eyes of 8 patients, 5 men and 3 women, with a median age of 43 years (mean 49, range 24-83) were identified. Clinical diagnosis was pterygium (n=4, 50%), inflamed pterygium (n=1, 13%), pterygium vs conjunctival squamous cell carcinoma (n=1, 13%), episcleritis vs inflamed pinguecula (n=1, 13%), and scleritis vs keratoacanthoma (n=1, 13%). Of 5 lesions with follow-up information, none recurred following excision with a median follow-up of 9 weeks (mean 19 weeks, range 1-61 weeks). Allergy/atopy was documented in 4 of 7 (57%) patients with available medical information. There were no other systemic associations. Histopathologically, actinic granuloma was associated with pterygium (n=6, 75%) and pinguecula (n=2, 25%). All lesions were composed predominantly of histiocytes and a variable number of foreign body-type giant cells associated with a focus of severe actinic elastosis. The inflammatory pattern was giant cell (n=4, 50%), sarcoidal (n=2, 25%), histiocytic (n=1, 13%), and combined histiocytic and sarcoidal (n=1, 13%). Conjunctival actinic granuloma has diverse clinical and histopathologic manifestations, which need to be distinguished from other autoimmune, neoplastic, and infectious etiologies. This lesion frequently occurs in pre-existing pterygium and pinguecula and may be associated with allergy and atopy.

Auricular cartilage versus donor sclera as a wrapping of hydroxyapatite orbital implants.

To retrospectively compare postoperative outcomes after primary enucleation and placement of a hydroxyapatite (HA) implant without wrapping, wrapped with auricular cartilage or donor sclera. Medical records of patients presented as intraocular tumor or severe ocular injury were identified from the electronic medical record system. Cases underwent enucleation and HA orbital implantation were enrolled in this study and were divided into 3 groups according to the wrapping material of HA implant. Cases with autogenous cartilage caps were enrolled in group A (n=11), with donor sclera caps in group B (n=12), and without any wrapping material in group C (n=9). Follow-ups were set at 1, 2wk, 1, 3, 6, and 12mo after surgery. Altogether 32 cases finished the follow-up and were enrolled in this study. Three cases (27.27%) in group A, 4 cases (33.33%) in group B, and 4 cases (44.44%) in group C developed one complication each after surgery. In group A, no HA exposure occurred, but conjunctival inclusion cyst occurred in one and severe conjunctive chemosis in two cases. In group B, one HA exposure occurred, conjunctive inclusion cysts occurred in one, severe conjunctive chemosis occurred in one, and conjunctival granuloma occurred in one case. In group C, one HA exposure occurred, severe conjunctive chemosis occurred in two cases, and conjunctival granuloma occurred in one case. The case of exposure of none-wrapped implant was noted in the first 6mo after placement of the orbital implant. The case of exposure of donor sclera-wrapped implant was noted at the 12mo after placement of the orbital implant. Both exposure cases were treated successfully with conservative treatment. With low incidence of implant exposure and mild complications, auricular cartilage can be a good choice of alternative wrapping material of orbit implant with satisfied outcome.

A good visual recovery in a patient with central retinal artery occlusion associated with Churg-Strauss syndrome: case report

Background: Churg-Strauss syndrome (CSS) is a rare systemic necrotizing vasculitis of unknown etiology that affects small-to-medium-sized vessels. A multisystem disease that mostly affects the lungs and the skin. In addition, it could affect the renal, cardiovascular, gastrointestinal, central, and peripheral nervous systems. Ocular involvement in the CSS is rare. The reported ocular manifestations include corneal ulcer, uveoscleritis, conjunctival granuloma, orbital inflammatory pseudotumor, amaurosis fugax, retinal artery occlusion, ischemic optic neuropathy, oculomotor nerve palsy, and trochlear nerve palsy. Case Presentation: A 53-year-old man was admitted with sudden visual loss. CSS was diagnosed earlier, based on asthma, eosinophilia, peripheral neuropathy symptoms, and pulmonary infiltrates. His vision was completely lost in the left eye. Unilateral central retinal artery occlusion (CRAO) was observed by fluorescence angiography. Results: The treatment modality used in our patient was steroid pulse therapy, and his vision improved 24 hours later. This outcome might emphasize the importance of steroid pulse therapy since it may be effective for CRAO in CSS patients. Conclusion: This case report described a CSS patient with associated CRAO, in whom steroid pulse therapy improved his visual acuity. Therefore, since intensive treatment should be administered as early as possible to improve the prognosis of vision, rheumatologists should be aware of the presence of CSS-associated CRAO, and they should refer those patients to ophthalmology as soon as possible.