Conjunctival Concretions

●Small, multiple, yellow-white lesions commonly found on palpebral conjunctiva of elderly individuals and those with chronic inflammation
●They are thought to be widespread and typically asymptomatic, occurring in 40-50% of the population

ETIOLOGY:
●Mostly associated with aging and chronic inflammation
●Long standing inflammation, such as chronic conjunctivitis ( trachoma or vernal), severe atopic conjunctivitis, and meibomian gland disease
Recrystallization of eye drops like sulfadiazine

PATHOLOGY:
●Degenerating epithelial cells and proteinaceous secretions from conjunctival glands
●Following inflammation, the debris becomes trapped in the subconjunctival depressions and recesses, and they often undergo calcification
●No role of goblet cells

DIAGNOSIS:
●Incidental finding on slit-lamp examination
●Patients usually asymptomatic
●Can have h/o chronic conjunctivitis

●Small 1-2 mm, chalky, yellow-white lesions typically on palpebral conjunctiva
●They may be singular, multiple, or rarely confluent
●Located on inferior tarsal and forniceal conjunctiva but can be superiorly located as well
●Rarely, the degenerated substances will become secondarily inflamed or may erode through overlying epithelium resulting in local irritation and foreign body sensation

D/D:
●Epidermal inclusion cysts
●Lymphoid follicles

TREATMENT:
●Observe
●If they erode though epithelium, they can often be removed with needlepoint forceps or a 30 gauge needle in the OPD
●In cases of foreign body sensation or persistent irritation, they may be removed surgically

Image from Rajan Eye Care Hospital

Visit our website www.ophthalmobytes.com

#ophthalmology #ophthal #doctor #health#medical #vision #education #optometry#medicalstudent #optometrist #medicine #eye#ophtho #ophthalmologist #medicaleducation#ophthalmologyresident#ophthalmologyresidency #apaoyo #cornea#conjunctiva #ocularsurface #concretions