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A retrospective study of conjunctival lesions in the Paediatric Eye Clinic over 12 years

Eye volume 38, pages 553–557 (2024)Cite this article

Subjects

Abstract

Background

Paediatric conjunctival lesions are rare and diverse. Though often indolent and asymptomatic, they can in some cases be sight or life-threatening. Awareness of concerning features of conjunctival lesions is key to optimal management. We aim to provide insight into management of paediatric conjunctival lesions though a review of cases in our service in last 12 years.

Methods

We present a retrospective analysis of our population-based cohort of children with conjunctival lesions presenting to our regional service in Belfast between 2011 and 2022 inclusive. We detail three rare cases of paediatric conjunctival lesions; a congenital intrascleral cyst leading to astigmatic amblyopia, a rapidly changing salmon-pink lesion confirmed as an embryonal rhabdomyosarcoma and an unusual presentation of a chronic granuloma arising from the caruncle.

Results

85 conjunctival lesions were identified in <16 year olds giving a cumulative incidence of 27 cases per 100,000 population over 12 years. Mean age at presentation was 7 years old. Most common lesions were naevi (40%), limbal dermoids (21%), conjunctival melanosis (14%), conjunctival cysts (7%) and phlycten (6%). When seen at presentation 8% of cases were immediately listed for surgery, 28% were discharged and 64% entered a phase of observation.

Conclusion

Paediatric conjunctival lesions have potential to cause visual manifestations, whilst some may undergo malignant transformation. Anterior segment photography is crucial in monitoring change and facilitating early discharge in the absence of sinister features. Malignant transformation must be considered in changing lesions which ought to have histological diagnosis obtained to prevent potentially sight and life-threatening conditions.

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Fig. 1: A congenital intrascleral cyst in the left eye.
Fig. 2: Conjunctival lesion caused by embryonal rhabdomyosarcoma in the lateral bulbar conjunctiva of the left eye.
Fig. 3: Left eye caruncular granuloma.

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Data availability

The datasets generated during the current study are not publicly available due to patient confidentiality, but details are available from the corresponding author on reasonable request. Written consent for publication was obtained from the relevant patients.

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Author notes

  1. These authors contributed equally: John Logan, Ajay Mohite.

Authors and Affiliations

  1. Royal Victoria Hospital, Belfast Health and Social Care Trust, Northern Ireland, UK

    John Logan, Ajay Mohite, Sonia George & Eibhlin Mcloone

  2. Southmead Hospital, North Bristol NHS Trust, England, UK

    Oliver Kemp

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  1. John Logan
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Contributions

EM and AM conceived and designed the project. JL and AM acquired the data and drafted the manuscript. OK, SG and EM revised the manuscript.

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Correspondence to John Logan.

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Logan, J., Mohite, A., Kemp, O. et al. A retrospective study of conjunctival lesions in the Paediatric Eye Clinic over 12 years. Eye 38, 553–557 (2024). https://doi.org/10.1038/s41433-023-02727-1

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