8 - Conjunctiva - Conjunctival Degenerations Flashcards
Pterygium
Raised triangular sub epi in growth
Stocker line, iron deposits
Recurrence with UV
Excision
Pingueculum
Raised yellow patch
Retention cysts
Clear fluid filled
Puncture
Conjunctivochalasis
Redundant conjunctival fold at lower lid margin
Lub
Concretions/lithiasis
Small chalky white dots
Remove with needle
Subconjunctival hemorrhage
Large area of blood covering sclera
Slit lamp, hyphema
No tx
1 in 6 months okay
Conjunctival pigmentation examples
Axenfeld loops
Conjunctival epithelial melanosis
Axenfeld loop
Melanosis around intrascleral nerve or ciliary artery
Conjunctival epithelial melanosis
Common in dark skinned people
Flat, patchy brown
More intense around limbus
Conjunctival nevus
Sharply demarcated
Conjunctival papilloma
Pedunculated - HPV types 6 and 11, and young, multiple
Sessile - middle-age, single, juxtalimbal
Limbal dermoid (epi bulbar choristoma)
Congenital overgrowth of normal tissue in a normal location
Soft yellow mass
associated with Goldenhar syndrome
Goldenhar syndrome
Oculoauriculovertebral spectrum
Jaw hypoplasia
Underdeveloped external ear
Lipodermoid
Soft movable mass
Avoid excision
Intraepithelial neoplasia
UV, HPV, aids
May progress into cornea
Excision, cryotherapy
Primary acquired melanosis (PAM)
Flat brown pigment anywhere on conj
Normal: basal conjunctiva, normal melanocytes, benign
Abnormal: all conjunctiva layers, increase in large melanocytes, premalignant
biopsy, excision, Cryo
Conjunctival melanoma
Feeder vessel are suspicious
arises from PAM, pre-existing nevus or primary
Squamous cell carcinoma
Fleshy pink mass with feeder vessels
Slow-growing and rarely metastasizes
Karposi sarcoma
Flat, slow-growing in AIDS patients
Flat bright red lesion in the lower fornix
Conjunctival lymphoma
Salmon pink mobile infiltrate
Radiotherapy
Metastasis
From breast cancer and lung cancer
To liver primarily, regional lymph nodes, lung, brain
