Ocular Tumors
 The most common melanocytic
tumor
 1st – 2nd decade
 Junctional, Compound or subepithelial
 Limbal, at plica or caruncle
 Signs of malignant
transformation
 Treatment: excision
Epithelial
melanosis
 Dark skinned, bilateral
 Flat, brown, limbal
Melanocytoma
 Rare, congenital
 Black
 Cannot be moved freely over the
globe
Papilloma
 HPV
 Fibro-vascular core, stratified
squamous non-keratinized
epithelium
 Sessile or pedunculated
 Treatment: excision + MMC or
cryotherapy to the base
Haemangioma
 Sturge Weber syndrome
Pyogenic
granuloma




Dermoid
 Choristoma
 Collagen wall, lined by stratified
squamous epithelium, containing
dermal elements
 Limbal
 Associations: Goldenhar, nevus
sebaceous of Jadassohn
 Complications: astigmatism,
dellen, irritation
 Treatment: excision ± lamellar
kerato-sclerectomy
Primary
Acquired
Melanosis
"PAM"
Malignant & pre-malignant Epi-bulbar tumors
Benign Epi-bulbar Tumors
Nevus
 Unilateral, old age, faire
complexion
 With atypia OR without atypia
 Uni- or multi-focal
 Dark brown
 Bulbar, palpebral
 Signs of malignant transformation
 Treatment: Excision with safety
margin + MMC or cryotherapy to
the base
Melanoma




Ocular
surface
squamous
neoplasia




"OSSN"
Lymphoproliferativ
e lesions
Fibro-vascular granulation tissue
Following trauma, surgery
Pink, fleshy, fast growing
Treatment: topical steroids ±
excision
Kaposi
sarcoma
De novo or after PAM, papilloma
Melanotic or Amelanotic
Fixed to sclera
Treatment: Excision with safety
margin + MMC or cryotherapy to
the base
 Poor prognostic factors
Risk factors: UVR, HPV, AIDS
Epithelial dysplasia or CIN or SCC
Interpalpebral; at limbus
Gelatinous mass OR leukoplakia
OR papillomatous
 Treatment: Excision with safety
margin + MMC or cryotherapy to
the base
 Reactive lymphoid hyperplasia
 De novo, extension from orbit or
part of systemic lymphoma
 Salmon pink infiltrate
 Treatment: radiotherapy,
chemotherapy, excision,
cryotherapy




AIDS
Spindle shaped cells, vascular
channels, inflammatory cells
DDx: subconjunctival
hemorrhage
Treatment: radiotherapy,
excision ± cryotherapy
Dermolipoma





Similar to dermoid + fatty
tissue
Soft, movable, upper
temporal
DDx: prolapsed orbital fat,
orbital lobe of lacrimal gland
Treatment: debulking
NB: excision cause scarring