Conjunctival Degeneration and Benign Tumors

Limbal Dermoid

A mass of normal tissue in an abnormal position (choristoma)

What population are limbal dermoids seen in?

children

Goldenhar or Treacher collins syndrome (eyelid colobomas)

What is the presentation of a limbal dermoid?

smooth subconj mass

may have protruding hair

can invade any layers of cornea (excessive depth --> astigmatism, amblyopia)

Where are limbal dermoid usually found?

inferior temporal

What is the treatment for Limbal Dermoid

Surgical—simple excision for small lesions to corneal transplants when the cornea is significantly involved. 

What is a dermolipoma?

mass of fatty tissue in abnormal position (outer canthus)

Who gets dermolipomas?

adults

What is the presentation of dermolipoma?

yellow subconj mass

keratinized/scaly surface

may contain hairs

Where are dermolipomas found?

outer canthus

What is the treatment for dermolipoma?

Debulking the mass. Surgery is rare because of complications

What is a pyogenic granuloma of the conj?

fibrovascular lesion formed due to surgery or injury

What is the presentation of a conj pyogenic granuloma?

dark pink/red fleshy conj mass or lid

rapid growing

bleed if touched

What is the treatment of conj pyogenic granuloma?

topical steroid

excision

What is racial melanosis (conjunctival epithelial melanosis)

Excessive melanin within basal layer of the conjunctival epithelial melanocytes.

When does racial melanosis present?

in childhood

What population is racial melanosis seen in?

darker skinned individuals

What is the presentation of racial melanosis

Bilateral condition (can be asymmetric)

flat + patchy brown pigmentation

Where is racial melanosis found?

bilateral but asymmetric

throughout conj, increased concentration near limbus