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PHOTO ESSAY
Year : 2014  |  Volume : 62  |  Issue : 7  |  Page : 809-811

Conjunctival intraepithelial neoplasia with corneal furrow degeneration


1 Oncology Service, Wills Eye Institute, Philadelphia, PA, USA; Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India
2 Oncology Service, Wills Eye Institute, Philadelphia, PA, USA
3 Department of Pathology, Wills Eye Institute, Philadelphia, PA, USA

Correspondence Address:
Carol L Shields
Oncology Service, Wills Eye Institute, Philadelphia, PA, USA

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Source of Support: Support provided by the Eye Tumor Research Foundation, Philadelphia, PA (PR, CLS, JAS) and the Noel T. and Sara L. Simmonds Endowment for Ophthalmic Pathology, Wills Eye Institute. The funders had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, and in the preparation, review or approval of the manuscript. Carol L. Shields, M.D. has had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis., Conflict of Interest: None


DOI: 10.4103/0301-4738.138625

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A 68-year-old man presented with redness of left eye since six months. Examination revealed bilateral corneal furrow degeneration. Left eye lesion was suggestive of conjunctival squamous cell carcinoma, encroaching on to cornea. Anterior segment optical coherence tomography (AS-OCT) confirmed peripheral corneal thinning. Fluorescein angiography confirmed intrinsic vascularity of lesion. Patient was managed with "no touch" surgical excision, dry keratectomy without alcohol, cryotherapy, and primary closure. Pathologic examination of removed tissue confirmed clinical diagnosis. Management of this particular case required modification of standard treatment protocol. Unlike the alcohol-assisted technique of tumor dissection described, ethyl alcohol was not used for risk of corneal perforation due to underlying peripheral corneal thinning. Likewise, topical steroids were withheld in the post-operative period. Three weeks post-operatively, left eye was healing well. Hence, per-operative usage of absolute alcohol and post-operative use of topical steroids may be best avoided in such eyes.


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