A man in his late 70s presented with a painless, progressive growth in the left eye, noticed for 4 months. Visual acuity was 20/20. A large gelatinous mass lesion with patchy pigmentation was present on the temporal conjunctiva and cornea. There were multiple intrinsic blood vessels, along with dilated episcleral feeder vessels. White keratin deposits were visible on the surface, and staining with Rose Bengal dye was positive (Figure, A). Regional lymph nodes were not enlarged. A diagnosis of ocular surface squamous neoplasia was made. Mitomycin C, 0.04%, eyedrops 4 times/d, 4 d/wk were prescribed. After 8 weeks of therapy, the lesion had shrunk dramatically (Figure, B) and could be easily excised, with histopathology confirming squamous dysplasia. Squamous neoplasia of the ocular surface has a multifactorial etiology, with actinic exposure, immunosuppression, human papillomavirus infection, and xeroderma pigmentosa being associated.1,2 Topical chemotherapy with mitomycin C or interferon alfa-2b can be a useful adjunct in management.3,4
Vazirani J, Mohapatra S. Ocular Surface Squamous Neoplasia. JAMA Ophthalmol. Published online February 01, 2016134(2):e153666. doi:10.1001/jamaophthalmol.2015.3666
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