8 - Conjunctiva - Conjunctival Degenerations

Question 0

Pterygium

Answer 0

Raised triangular sub epi in growth
Stocker line, iron deposits
Recurrence with UV
Excision

Question 1

Pingueculum

Answer 1

Raised yellow patch

Question 2

Retention cysts

Answer 2

Clear fluid filled

Puncture

Question 3

Conjunctivochalasis

Answer 3

Redundant conjunctival fold at lower lid margin

Lub

Question 4

Concretions/lithiasis

Answer 4

Small chalky white dots

Remove with needle

Question 5

Subconjunctival hemorrhage

Answer 5

Large area of blood covering sclera
Slit lamp, hyphema
No tx
1 in 6 months okay

Question 6

Conjunctival pigmentation examples

Answer 6

Axenfeld loops

Conjunctival epithelial melanosis

Question 7

Axenfeld loop

Answer 7

Melanosis around intrascleral nerve or ciliary artery

Question 8

Conjunctival epithelial melanosis

Answer 8

Common in dark skinned people
Flat, patchy brown
More intense around limbus

Question 9

Conjunctival nevus

Answer 9

Sharply demarcated

Question 10

Conjunctival papilloma

Answer 10

Pedunculated - HPV types 6 and 11, and young, multiple

Sessile - middle-age, single, juxtalimbal

Question 11

Limbal dermoid (epi bulbar choristoma)

Answer 11

Congenital overgrowth of normal tissue in a normal location
Soft yellow mass
associated with Goldenhar syndrome

Question 12

Goldenhar syndrome

Answer 12

Oculoauriculovertebral spectrum
Jaw hypoplasia
Underdeveloped external ear

Question 13

Lipodermoid

Answer 13

Soft movable mass

Avoid excision

Question 14

Intraepithelial neoplasia

Answer 14

UV, HPV, aids
May progress into cornea
Excision, cryotherapy

Question 15

Primary acquired melanosis (PAM)

Answer 15

Flat brown pigment anywhere on conj
Normal: basal conjunctiva, normal melanocytes, benign
Abnormal: all conjunctiva layers, increase in large melanocytes, premalignant
biopsy, excision, Cryo

Question 16

Conjunctival melanoma

Answer 16

Feeder vessel are suspicious

arises from PAM, pre-existing nevus or primary

Question 17

Squamous cell carcinoma

Answer 17

Fleshy pink mass with feeder vessels

Slow-growing and rarely metastasizes

Question 18

Karposi sarcoma

Answer 18

Flat, slow-growing in AIDS patients

Flat bright red lesion in the lower fornix

Question 19

Conjunctival lymphoma

Answer 19

Salmon pink mobile infiltrate

Radiotherapy

Question 20

Metastasis

Answer 20

From breast cancer and lung cancer

To liver primarily, regional lymph nodes, lung, brain