Parinaud's Oculoglandular Syndrome (POGS) is a rare and atypical form of granulomatous conjunctivitis, classically composed of a triad: fever, unilateral granulomatous follicular conjunctivitis and preauricular satellite lymphadenopathy or ipsilateral submandibular, commonly related to cat scratch disease caused mainly by Bartonella henselae, or also caused, even if not tipically, by Sporothrix schenckii. In endemic areas, such as in South America, especially Brazil and Peru, ocular sporotrichosis, associated with POGS, should be considered a diagnostic hypothesis of ophthalmic diseases especially if this patient has a history of contact with cats . Itraconazole must be the first choice of medication for treatment and this patient would need assistance until complete clinical improvement, with family members oriented about possible sources of contamination, being important the early and appropriate treatment, due to the risk of eye sequelae . As a neglected public health problem in Brazil, where there has been a large increase in cases in the last decades, an accurate understanding of this disease is essential, with focus in the southeast region, mostly in the state of Rio de Janeiro.

Epithelial downgrowth (ED) after penetrating keratoplasty (PK) is a rare but troublesome complication, often leading to vision loss. We present a case of refractory ED and review of the literature on ED after keratoplasty. Case presentation and literature review was the study design. Intracameral 5-fluorouracil at the time of wound revision and placement of a tube implant for glaucoma control were successful in securing the closure of a fistulous wound after multiple transplant surgeries. In this case, the successful management of ED after PK was achieved with meticulous wound closure, adequate pressure control, and the mitigation of ED with chemoablation of the proliferating epithelial cells. More advanced cases may require repeated injections of antiproliferative medication, cryotherapy, or surgical excision of involved tissues.