Conjunctival mucosa-associated lymphoid tissue lymphoma classically presents as a subconjunctival mass, most often in the fornix. The presence of conjunctival mucosa-associated lymphoid tissue lymphoma with spread down the nasolacrimal duct has only been reported once previously. The authors present a case of a 35-year-old woman with a right conjunctival mass in the inferior fornix along with sinus congestion and fullness. A biopsy of the conjunctival mass and the nasal turbinate revealed a conjunctival mucosa-associated lymphoid tissue lymphoma. Therefore, it is important to consider spread down the nasolacrimal duct in patients with conjunctival lymphoma also presenting with difficulty breathing or nasal congestion.
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