Nodule at the limbus
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Transcript of Nodule at the limbus
Limbus is the transitional zone at the junction of the sclera and the cornea.
1 mm wide
Duration Slow or fast growing Vascular /non vascular H/o trauma or surgery Change in colour Associated symptoms Progression of growth
Congenital Inflammatory Allergic Vascular Traumatic Degenerative Nutritional Neoplastic miscellaneous
1. Dermoid2. Dermolipoma3. Raised Naevus
DERMOID Yellowish white mass Consists of epithelium , sebaceous
gland, hair Treatment: Excision
DERMOLIPOMA
soft , yellow and movable Subconjunctival mass Adipose tissue & dermis
around Associated with Goldenhar’s
syndrome
Flat or raised ,grey gelatinous ,brown,black
Tendency to grow during puberty and pregnancy
May undergo malignant change
Treatment: excision if it grows
Episcleritis Scleritis
EPISCLERITIS Inflammation of deep conjunctival
tissue Pinkish elevated tender nodule or
diffuse Occurs in
gout ,Rheumatism ,endogenous allergy to bacteria
Treatment: topical steroids or NSAIDs Systemic Indomethacin Recurrence – systemic
therapy
SCLERITIS– Nodular or diffuse form Nodule is fixed to sclera Pain and uveitis Causes– collagen
disorders,Endogenous infections.
Treatment: steroids
Phlycten Vernal catarrah– limbal
form Ophthalmia nodosa
Pinkish white nodules surrounded by congestion
causes photophobia , lacrimation , blepharospasm
Endogenous reaction to tuberculous protein
Treatment: topical steroids and treat the cause
Multiple nodules in the upper limbus , white superficial spots
White ropy discharge Hypersensitivity to exogenous
allergen – pollen and dust Recurrence occurs in summer Common in children Treatment : steroids , mast
cell stabilizers, NSAIDs
Granulomatous inflammation to caterpillar hair
Treatment: steroid or excision
Benign red lesion which blanches on pressure
Bleeds on trivial trauma May be associated with
hemangioma of lid and orbit
Granuloma Implantation cyst Iris prolapse covered by conjunctiva
GRANULOMA After surgical wound (squint or
pterygium surgery) Site of foreign body Treatment – surgical excision
Pingecula Cystic pterygium
Triangular yellow patch on nasal limbus
Occurs in elderly Hyaline infiltration with
elastotic degeneration of subconjunctival tissue
Treatment – excision for cosmetic purposes
Triangular sheet of fibrovascular tissue invading cornea
Occurs after recurrence Treatment – excision and
auto conjunctival transplantation
Silvery white, foamy or cheesy patch
Keratinised epithelium – temporal limbus
Seen in vitamin A deficiency
Papilloma Intraepithelial
epithelioma Squamous cell carcinoma Primary melanoma
Benign polypoid tumour Sessile/peduncle Can become malignant Treatment: surgical excision
SQUAMOUS CELL CARCINOMA Flat granular growth Invades underlying
structures Requires early excision
Nodular form, may be pigmented or non-pigmented
Treatment - excision
Intercalary or ciliary staphyloma
Filtering bleb – following trabeculectomy
Parasitic cyst – cysticercosis
Retention cyst
Bulge in limbal area Lined by root of iris due to
ectasia of weak scar tissue Following healed perforation
injuries or corneal ulcer
Thin walled cyst with clear fluid
Excision indicated if there is irritation or foreign body sensation or for cosmetic purposes