A case of ocular (bulbar) rhinosporidiosis is described; its unusual features included a) the rapid development of a primary, rhinosporidial lesion with a scleral staphyloma, close to but noncontiguous with the rhinosporidial lesion, 3 weeks after exposure to a lacustrine reservoir, the putative source of the pathogen Rhinosporidium seeberi; b) ocular coherence tomography which revealed no retinal abnormalities unlike in previous cases reported from Sri Lanka; c) atypical histopathology that resulted in an initial mis-diagnosis of chronic inflammation with mucus cysts and a missed diagnosis of rhinosporidiosis; the rhinosporidial etiology was confirmed on replicate histopathological sections of the ocular mass. The pitfalls of histopathological diagnosis of rhinosporidiosis are pointed out.
Keywords: missed diagnosis; rhinosporidiosis; staphyloma.