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    AAO2021 Video Program
    Ocular Pathology/Oncology

    Pigmented lesions in the conjunctiva can be baffling to both the patient and the treating ophthalmologist because of their varied range of presentation and overlapping clinical features. The lesions range from incidental pigment deposition such as mascara and complexion-associated melanosis to malignant melanoma, which poses a risk to life. Similarly, the management ranges from observation at regular intervals to aggressive surgery, like exenteration. Here we present a crisp and precise video of the good, the bad and the ugly pigmented lesions of the conjunctiva, highlighting their specific clinical features important for diagnosis and management.