Conjunctival Intraepithelial Neoplasia in a Patient Presenting with Pigmented Conjunctival Lesion

We report a case of conjunctival intraepithelial neoplasia (CIN) in a patient presenting with the pigmented conjunctival lesion.<b><i></i></b>This study involved a 56-year-old woman that presented with right eye irritation for 1 month. She noticed brownish pigmentation arising from her right nasal conjunctiva and growing slowly over time. Biomicroscopic examination showed a gelatinous pigmented conjunctival mass with feeder vessels. Conjunctival impression cytology (CIC) was done and reported as CIN. Treatment was started with 0.02% mitomycin-C eye drops. The conjunctival lesion responded well to medication. This report shows that CIN can manifest as a pigmented tumor, resembling melanoma. CIC plays a role in the diagnosis of this condition. This tumor responded well with 0.02% mitomycin-C eye drops.

Amyloidosis in the Palpebral Conjunctiva Mimicking Lymphoproliferative Lesion

A 47-year-old Japanese woman presented with a 1-year history of foreign body sensation in the right eye. Upon examination, a linear soft tissue lesion in the lower conjunctival fornix was noted. The mass resembled a conjunctival lymphoproliferative lesion but was pinkish-yellow rather than salmon pink in color. Histopathology of the biopsy specimens revealed amyloidosis. Systemic workup showed no other lesions. The conjunctival lesion did not recur at 3 months postoperatively. Since conjunctival amyloidosis mimics conjunctival lymphoproliferative lesions, it is important to keep conjunctival amyloidosis as a differential diagnosis in the diagnosis of a pinkish conjunctival lesion.

Successful surgical management of large conjunctival nevus in a 10-year-old child with resection and amniotic membrane transplantation

The purpose of this paper is to illustrate a case of large conjunctival nevus in a 10-year-old boy which was successfully treated with surgical excision and amniotic membrane transplant (AMT) reconstruction. The conjunctival nevus was initially noticed by the parents 1 year prior to presentation; they reported it had increased in size over the past 3 months. Slit-lamp examination revealed a pigmented conjunctival nevus measuring 5.5 mm vertically and 6.5 mm horizontally, with well-demarcated margins and presence of an intralesional cyst at the temporal bulbar conjunctiva, involving the limbus and encroaching onto the cornea. Complete resection of the conjunctival lesion and bulbar conjunctival reconstruction were performed. The histopathological examination showed conjunctival nevus. The wound healed well with vision of 6/6 and no recurrence. Surgical resection combined with AMT is a successful and an effective way to treat conjunctivalnevus.

Clinical profile of ocular surface tumours at a tertiary care centre

Background: Corneal and conjunctival squamous lesions are uncommon but important because of their potential for causing ocular and even systemic morbidity and mortality. The ocular surface tumors can be congenital or acquired and show a broad spectrum ranging from non-neoplastic benign tumours and others demonstrate premalignant or malignant tumours such as Squamous cell carcinoma, Malignant Melanoma or Kaposi Sarcoma. The types and frequency of conjunctival tumours differ with demographic features such as age and race, systemic immune status, and chronic exposures, along with specific location within the conjunctiva. Objectives of this study was to study ocular surface neoplasm in terms of demographics, histopathological and clinical presentation.Methods: This histopathological, prospective biopsy specimen series comprised of 107 patients of either sex and all age groups presenting with conjunctival lesion either benign or malignant. The study was carried out from December, 2017 to December, 2019 in the Department of Ophthalmology, S. P. Medical College and Associated Group of Hospitals, Bikaner in collaboration with Pathology Department. All enrolled cases of conjunctival lesion were screened by consecutive sampling after obtaining written consent.Results: 39.25% patients had nevus followed by ocular surface squamous neoplasia (OSSN) (20.56 %). Various ocular surface neoplasia with respect to mean age, age group, occupation was statistically highly significant (p<0.05) whereas gender was statistically non-significant. On histopathological examination most common benign ocular surface neoplasia was nevus and most common malignant tumor was ocular squamous surface neoplasia (OSSN).Conclusions: A large variety of conjunctival lesions may appear in the eye with variable presentation, most common benign ocular surface neoplasia was nevus and most common malignant tumor was ocular squamous surface neoplasia.

Intra-Scleral Blue Nevus Arising within Oculodermal Melanocytosis: Melanoma or Not?

We report a 61-year-old female who presented to our service with recent growth of a thickened, pigmented, sub-conjunctival lesion within an area of ocular melanocytosis in her left eye. Lamellar sclerectomy was performed. Histopathological assessment revealed a localized melanocytic proliferation with features of blue nevus arising within the area of ocular melanocytosis. There was a small zone of cells showing cytological atypia and expansion of the scleral stroma. We believe this case to be the first report of intrascleral blue nevus arising within an area of ocular melanocytosis. Given the cytological atypia, the blue nevus may perhaps represent an intermediate stage within a progression from ocular melanocytosis towards melanoma. Patients with oculodermal melanocytosis merit regular long-term surveillance for early detection of melanoma, not only in the uvea, but also in the orbit and potentially the ocular surface.

Assessing Profile and Treatment Outcome in Patients of Ocular Surface Squamous Neoplasia (OSSN)

Purpose: This study has attempted to assess the profile and treatment outcome of patients with OSSN and report the recurrence rate following treatment of primary OSSN. Materials and Methods: This was a retrospective, non-comparative hospital based observational study. The case files of OSSN patients from Jan 2010 to Dec 2017were assessed. The study site was Himalaya Eye Hospital, Gharipatan, Pokhara. This hospital is the only eye hospital in province 4, Nepal. All the files of suspicious cases of conjunctival mass or OSSN were reviewed. Data regarding demographic characteristics, vision acuity, involved eye, clinical features, conjunctival lesion type, duration of symptoms, preoperative clinical diagnosis, history, other eye disease, associated systemic diseases, occupation as well as treatment modalities of the patients and its outcome were taken. Results: Out of 40 cases, females were 21(52.5%) vesus 19(47.5%) male. Amongthem, 19 patients had keratinized stratified squamous epithelium, 17 had conjunctiva intraepithelial squamous neoplasia and 4 had invasive squalors cell carcinoma. Predominance age group was 15-59 age (25/40, 62.5%), among which 12 had keratinized stratified squamous epithelium, 11 conjunctival intraepithelial squamousneoplasia and 2 had invasive squamous cell carcinoma conjunctival lesion. The mean duration of symptoms was about nine months (S.D. = 5.972). The mean size of lesion mass was 3.28 mm (SD=1.569). More than half of the cases (55%, 22/40) had the mass located at nasal limbus. 95% (38/40) cases underwent lesion total excision and direct closure and 5% (2/40) underwent lesion excision followed by Amniotic Membrane grafting. Only 5% (2/40) cases, those who had undergone lesion excision, the lesion recurrence was observed during follow up period of 31 months. Conclusion: The outcome of the OSSN following the treatment was found to be satisfactory. Further studies with prolonged follow-up are recommended to evaluate the risk of recurrence and other adverse effects.