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Make your diagnosis in the comments, and look for the answer in next month’s Blink.

Last Month’s Blink

Large, Benign Conjunctival Squamous Papilloma

Written by Katherine Loomba, BS, and Alanna Nattis, DO, FAAO, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, N.Y., and SightMD, Babylon, N.Y., respectively. Photo by Alanna Nattis, DO, FAAO.

A 56-year-old woman with no significant past medical or ocular history complained of a “pink spot” affecting the closure of her left eye—and noted that it had quadrupled in size over one year. She denied irritation or change in vision but had 2 mm of mechanical lagophthal­mos and exposure. Best-corrected visual acuity was 20/25 in the right eye and 20/30 in the left. On exam, an 8-mm smooth, dome-shaped, pink nodular growth was seen firmly affixed to the temporal aspect of the left globe with 2+ overlying lissamine green stain. Gonioscopy in the left eye showed open angles without evidence of increased pigmentation, masses, or deep ocular invasion. The remainder of the exam was unremarkable. Based on history of aggressive growth, obstruc­tion of normal eyelid function, and progression of ocular surface dryness, a decision was made to excise the lesion using a no-touch technique. Histopathologic diagnosis was squamous papil­loma without evidence of atypia and tumor-free margins. The patient was given antibiotic and steroid drops for one month; she has not experi­enced recurrence to date. Her lagophthalmos is much improved.

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