A 47-year-old woman with poorly controlled asthma and
allergic rhinitis presented with recurrent episodes of
bilateral upper eyelid swelling associated with forniceal
conjunctival mass for the past 10 years. Routine blood
investigations showed raised IgE levels and raised
eosinophil counts. The diagnosis of Churg-Strauss
syndrome (CSS) was made following biopsy of the
conjunctival mass. The symptoms responded well to oral
steroid treatment but recurred following cessation of the
therapy. The patient was co-managed with a rheumatologist
and the patient currently remains stable and is on oral
Methotrexate and low dose oral steroids. Ocular
involvement in CSS is unusual but this unique presentation
of CSS was successfully managed, and the patient remains
in remission.