Pseudopemphigoid: Sarcoidosis presenting as cicatricial conjunctivitis with symblepharon

Conjunctival involvement in sarcoidosis is commonly characterized by epibulbar nodules or follicular conjunctivitis. The authors describe an apparently healthy woman who developed extensive monocular cicatricial conjunctivitis with symblepharon. The array of conditions presenting with cicatricial conjunctivitis was considered, with mucous membrane pemphigoid leading the diagnostic possibilities. Conjunctival biopsy disclosed the non-infectious, non-caseating granulomas of sarcoidosis and a systemic evaluation disclosed pulmonary nodules and hilar lymphadenopathy. As the patient had no respiratory symptoms and an old history of hepatic steatosis, oral hydroxychloroquine and topical cyclosporin were chosen for therapy rather than systemic corticosteroids.

Primary acquired melanosis (PAM) without atypia/WHO low-grade conjunctival melanocytic intraepithelial lesion over areas of oculodermal melanocytosis

An elderly white man with a history of left oculodermal melanocytosis presented with new onset brown pigmentation of the left bulbar and inferior tarsal conjunctiva. The bulbar conjunctival pigmentation was at the level of the conjunctival epithelium and was overlying areas of typical slate-grey scleral pigmentation characteristic of oculodermal melanocytosis. Both areas of new pigmentation were biopsied. The bulbar conjunctiva revealed primary acquired melanosis (PAM) without atypia with increased melanin production and the tarsal conjunctival biopsy showed PAM without atypia sine pigmentio overlying areas of substantia propria spindle-shaped heavily pigmented melanocytes of oculodermal melanocytosis. The case report examines the relationship between the epithelial and substantia propria melanocytes and correlates the findings with what is known about this association from the dermatopathology literature.

Raised Superior Bilateral Conjunctival Lesions: An Exploration of Conjunctival Lymphangioma and Haemangioma

This report is based on the case of a young 7-year-old child who presented with a four-month history of raised superior conjunctival lesions in both eyes and subsequently underwent a conjunctival biopsy in the right eye. He was not known to have any underlying congenital disorders and subsequent biopsy revealed an epithelium consisting of irregular, ectatic thin-walled channels lined by a bland single layered epithelium which expressed both CD31 and D240. No Cytokeratin (Cam 5.2) or EMA was expressed in the subsequent report. It was concluded that the features highlighted were likely due to an underlying conjunctival lymphangioma or haemangioma – which we will explore further.

Immunoglobulin Heavy Chain Gene Rearrangement Studies in the Diagnosis of a Paediatric Conjunctival Lesion

We present a case whereby standard immunohistochemistry and flow cytometry studies for a conjunctival biopsy were unable to reliably differentiate between the two distinct pathological processes of benign reactive lymphoid hyperplasia from conjunctival lymphoma. A tissue diagnosis was only able to be conclusively attained after the application of immunoglobulin heavy chain rearrangement studies to the specimen. This is unusual and to our knowledge has not been previously expressed in the literature. Hence, the use of these further molecular studies may have great potential clinical implications in helping resolve such diagnostic dilemmas.

Conjunctival cytology assessment in dogs and cats. Sampling, diagnostic techniques and findings

The conjunctiva provides a physical and physiological barrier against microorganisms and foreign bodies and also contributes to the ocular immunological defense. It constitutes a straightforward and accessible tissue for sampling and examination. Sampling indications include: changes in color, surface irregularities, thickening, or masses, ocular discharge and the identification of infectious organisms. Samples for conjunctival evaluation may be collected with exfoliative or abrasive techniques, aspiration, impression and conjunctival biopsy. The most commonly used and clinically useful laboratory methods for the assessment of conjunctival specimens are: microscopic examination of cytological preparations, culture and susceptibility testing, live virus isolation, polymerase chain reaction, direct immunofluorescent antigen test and histopathological examination for snip biopsies. Findings like inflammatory or neoplastic cells, cellular alterations, inclusion bodies and microorganisms, offer valuable information not only for localized ocular disorders, but for systemic diseases as well.