Conjunctivitis as a manifestation of Wegener's Granulomatosis

Purpose: to report a case of prolonged conjunctivitis as the manifestation of granulomatosis with polyangiitis (gpa). methods: a 37-year-old man presented with prolonged conjunctivitis which had persisted for one month. he was taking medication for his conjunctivitis without any response. a slit-lamp examination revealed conjunctivitis and scleritis in the right eye. conjunctivitis, 360-degree peripheral corneal thinning, corneal perforation, and scleritis were seen in the left eye. results: emergency penetrating keratoplasty was performed to treat the patient's corneal perforation. after a consultation with the internal medicine department, the patient was suspected of having gpa with positive cytoplasmic anti-neutrophil cytoplasmic antibodies (c-anca). functional endoscopic sinus surgery was performed to treat right maxillary sinusitis, and a biopsy of the maxillary sinus mucosa was obtained. the pathology report showed granuloma and vasculitis with severe acute and chronic inflammation and few eosinophils; thus, the diagnosis was confirmed. conclusion: because prolonged conjunctivitis occurs only rarely in association with systemic disease, ophthalmologists should be aware of this potential, particularly in patients with gpa.