DOI: 10.36347/sjams.2018.v06i09.034

Pages: 3400-3405

Conjunctival lithiasis in children is very rare, with a single case reported in literature to the best of our knowledge. The present study constituted twelve cases of children presenting to Sarojini Devi Eye Hospital, Hyderabad between December 2013 to November 2017 with the complaint of formation of stones in their eyes. The cytological examination of material formed in the lower conjunctival fornix and that of the crushed stone was done. Microbiological culture and biochemical analysis of the stones was done. Conjunctival biopsies taken from the lower conjunctival fornix were fixed in 10% formalin, processed routinely, stained with Hematoxylin & Eosin and special stains. Stones were sent for biochemical analysis. The cytology, histopathology, and microbiology and biochemical findings are correlated. The cytohistological findings revealed branched fungal hyphae, calcium oxalate crystals and dark brown to black pigment deposits. A diagnosis of Aspergillusniger was made. Microbiological culture showed fungal growth consistent with Aspergillusniger on microscopy. Biochemical analysis showed that the stones were composed of calcium compounds. Aspergillus niger releases a mycotoxin, oxalic acid which complexes with calcium ions in tear fluid to precipitate as calcium oxalate crystals. Crystallogenesis is essential to stone formation. The probable mechanism of conjunctival stone formation and possible factors responsible for the rapid formation of conjunctival stones are analysed.