Rasan Burhan and Lana Faraj
Queens Medical Centre Nottingham, UK
Scientific Tracks Abstracts: J Clin Exp Ophthalmol
This report describes the case of a young 7-year-old child who presented with a four-month history of raised superior conjunctival lesions in both eyes and subsequently underwent a conjunctival biopsy in the right eye. He was not known to have either of the congenital disorders and subsequent biopsy revealed an epithelium consisting of irregular, ectatic thin-walled channels lined by a bland single layered epithelium which expressed both CD31 and D2-40. No cytokeratin (Cam 5.2) or EMA was expressed in the report. It was concluded that the features highlighted were most probably due to an underlying conjunctival haemangioma or lymphangioma which we will explore further. Conjunctival Lymphangioma A Conjunctival lymphangioma is a rare disorder of the eye which appears as a multi-loculated cyst-like lesion on the surface of the conjunctiva. It is characterised by dilation of the lymphatic vessels and is also known to have the potential for recurrence. 1They are benign and slow-growing;usually presenting as a mass - which does not generally affect the vision of the sufferer.2 It is usually noted to be a unilateral condition so it is somewhat rare to find patients with a bilateral manifestation. If it is bilateral then it is generally known to be associated with Milroy’s disease or Turner syndrome. Milroy’s Disease is also known as Nonne–Milroy–Meige. This is a familial condition leading to lymphoedema due to abnormalities of congenital origin (inherited in an autosomal dominant manner) in the lymphatic system.3 Turners syndrome is a female only condition which is characterised by short stature and premature ovarian failure amongst a myriad of signs such amenorrhoea, webbed neck and heart problems including but not limited to aortic valve stenosis, coarctation of the aorta, bicuspid aortic valve (most common). It is caused by a partially or completely missing X-chromosome. 4 Conjunctival Haemangioma A Conjunctival haemangioma on the other hand is also an uncommon and somewhat rare occurrence. 5They are known to account for approximately 2% of neoplasms involving the conjunctiva. 6Additionally, they tend to affect younger individuals.7Generally, in the second to third decade of life. It can present with bleeding of the conjunctiva. 8 Management and treatment of conjunctival haemangioma involves taking into consideration the extent and size of the lesion. The most common of these are an excisional biopsy. There are a multitude of other treatment options including cryotherapy, radiotherapy, chemotherapy as well as enucleation and exoneration in more pressing cases.