副鼻腔炎手術で軽快した片眼性慢性結膜炎の1例

Surgery for paranasal sinusitis was effective in a case with unilateral chronic conjunctivitis

要約　目的：副鼻腔炎手術により軽快した片眼性慢性結膜炎を経験したので報告する。

症例：73歳，女性。2012年より右眼違和感を自覚し，近医で抗菌薬点眼を処方されたが軽快せず，2014年11月当院受診。右眼の眼瞼腫脹，眼脂が強く，眼瞼結膜に濾胞・乳頭形成，角膜に混濁がみられ，右視力（0.2）。右眼のみ通水検査で逆流があった。

結果：右鼻涙管にチューブを留置し症状は軽快したが，再燃を繰り返した。頭部MRIで副鼻腔炎がみられ耳鼻科併診。2015年5月に両側汎副鼻腔炎根治術施行。術直後より眼脂が消失，術後1か月には右（0.8）まで改善。術後3か月には角膜・結膜所見も改善。

結論：副鼻腔炎に結膜炎を合併することがあり注意が必要である。

Abstract　Purpose: To report a case who had unilateral chronic conjunctivitis and who responded to surgery for paranasal sinusitis.

Case: A 73-year-old woman presented with swelling of eyelid and discharge in the right eye. She had felt discomfort in the right eye since 2 years before and had been treated with topical antibiotics. She had received surgery for left paranasal sinusitis 3 years before.

Findings and Clinical Course: Corrected visual acuity was 0.2 right and 0.9 left. The right conjunctiva showed follicles. The right nasolacrymal tube resisted passage of water. Magnetic resonance imaging showed paranasal sinusitis. Eye discharge disappeared following bilateral endoscopic sinus surgery. Right visual acuity improved to 0.8 one month after. Findings of the cornea and conjunctiva improved 3 months later.

Conclusion: The present case illustrates that chronic conjunctivitis may be due to paranasal sinusitis. Early diagnosis is important for adequate treatment and prevention for recurrence.