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 Limbus is the transitional zone at
the junction of the sclera and the
cornea.
 1 mm wide
 Duration
 Slow or fast growing
 Vascular /non vascular
 H/o trauma or surgery
 Change in colour
 Associated symptoms
 Progression of growth
 Congenital
 Inflammatory
 Allergic
 Vascular
 Traumatic
 Degenerative
 Nutritional
 Neoplastic
 miscellaneous
1. Dermoid
2. Dermolipoma
3. Raised Naevus
DERMOID
 Yellowish white mass
 Consists of epithelium , sebaceous gland,
hair
 Treatment: Excision
DERMOLIPOMA
 soft , yellow and movable
 Subconjunctival mass
 Adipose tissue & dermis around
 Associated with Goldenhar’s
syndrome
 Flat or raised ,grey gelatinous
,brown,black
 Tendency to grow during puberty
and pregnancy
 May undergo malignant change
 Treatment: excision if it grows
 Episcleritis
 Scleritis
 EPISCLERITIS
 Inflammation of deep conjunctival tissue
 Pinkish elevated tender nodule or diffuse
 Occurs in gout ,Rheumatism
,endogenous allergy to bacteria
 Treatment: topical steroids or NSAIDs
Systemic Indomethacin
Recurrence – systemic therapy
SCLERITIS–
 Nodular or diffuse form
 Nodule is fixed to sclera
 Pain and uveitis
 Causes– collagen
disorders,Endogenous infections.
 Treatment: steroids
 Phlycten
 Vernal catarrah– limbal form
 Ophthalmia nodosa
 Pinkish white nodules surrounded
by congestion
 causes photophobia ,
lacrimation , blepharospasm
 Endogenous reaction to
tuberculous protein
 Treatment: topical steroids and
treat the cause
 Multiple nodules in the upper
limbus , white superficial spots
 White ropy discharge
 Hypersensitivity to exogenous
allergen – pollen and dust
 Recurrence occurs in summer
 Common in children
 Treatment : steroids , mast cell
stabilizers, NSAIDs
 Granulomatous inflammation
to caterpillar hair
 Treatment: steroid or excision
 Benign red lesion which blanches
on pressure
 Bleeds on trivial trauma
 May be associated with
hemangioma
of lid and orbit
 Granuloma
 Implantation cyst
 Iris prolapse covered by conjunctiva
GRANULOMA
 After surgical wound (squint or pterygium
surgery)
 Site of foreign body
 Treatment – surgical excision
 Pingecula
 Cystic pterygium
 Triangular yellow patch on nasal
limbus
 Occurs in elderly
 Hyaline infiltration with elastotic
degeneration of subconjunctival
tissue
 Treatment – excision for cosmetic
purposes
 Triangular sheet of fibrovascular
tissue invading cornea
 Occurs after recurrence
 Treatment – excision and auto
conjunctival transplantation
 Silvery white, foamy or cheesy
patch
 Keratinised epithelium –
temporal limbus
 Seen in vitamin A deficiency
 Papilloma
 Intraepithelial epithelioma
 Squamous cell carcinoma
 Primary melanoma
 Benign polypoid tumour
 Sessile/peduncle
 Can become malignant
 Treatment: surgical excision
SQUAMOUS CELL CARCINOMA
 Flat granular growth
 Invades underlying structures
 Requires early excision
 Nodular form, may be
pigmented or non-pigmented
 Treatment - excision
 Intercalary or ciliary
staphyloma
 Filtering bleb – following
trabeculectomy
 Parasitic cyst – cysticercosis
 Retention cyst
 Bulge in limbal area
 Lined by root of iris due to ectasia
of weak scar tissue
 Following healed perforation
injuries or corneal ulcer
 Thin walled cyst with clear fluid
 Excision indicated if there is
irritation or foreign body sensation
or for cosmetic purposes
Nodule at the limbus
Nodule at the limbus

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Nodule at the limbus

  • 1.
  • 2.  Limbus is the transitional zone at the junction of the sclera and the cornea.  1 mm wide
  • 3.  Duration  Slow or fast growing  Vascular /non vascular  H/o trauma or surgery  Change in colour  Associated symptoms  Progression of growth
  • 4.  Congenital  Inflammatory  Allergic  Vascular  Traumatic  Degenerative  Nutritional  Neoplastic  miscellaneous
  • 5. 1. Dermoid 2. Dermolipoma 3. Raised Naevus DERMOID  Yellowish white mass  Consists of epithelium , sebaceous gland, hair  Treatment: Excision
  • 6.
  • 7. DERMOLIPOMA  soft , yellow and movable  Subconjunctival mass  Adipose tissue & dermis around  Associated with Goldenhar’s syndrome
  • 8.  Flat or raised ,grey gelatinous ,brown,black  Tendency to grow during puberty and pregnancy  May undergo malignant change  Treatment: excision if it grows
  • 9.
  • 10.  Episcleritis  Scleritis  EPISCLERITIS  Inflammation of deep conjunctival tissue  Pinkish elevated tender nodule or diffuse  Occurs in gout ,Rheumatism ,endogenous allergy to bacteria  Treatment: topical steroids or NSAIDs Systemic Indomethacin Recurrence – systemic therapy
  • 11.
  • 12. SCLERITIS–  Nodular or diffuse form  Nodule is fixed to sclera  Pain and uveitis  Causes– collagen disorders,Endogenous infections.  Treatment: steroids
  • 13.
  • 14.  Phlycten  Vernal catarrah– limbal form  Ophthalmia nodosa
  • 15.  Pinkish white nodules surrounded by congestion  causes photophobia , lacrimation , blepharospasm  Endogenous reaction to tuberculous protein  Treatment: topical steroids and treat the cause
  • 16.
  • 17.  Multiple nodules in the upper limbus , white superficial spots  White ropy discharge  Hypersensitivity to exogenous allergen – pollen and dust  Recurrence occurs in summer  Common in children  Treatment : steroids , mast cell stabilizers, NSAIDs
  • 18.
  • 19.  Granulomatous inflammation to caterpillar hair  Treatment: steroid or excision
  • 20.
  • 21.  Benign red lesion which blanches on pressure  Bleeds on trivial trauma  May be associated with hemangioma of lid and orbit
  • 22.
  • 23.  Granuloma  Implantation cyst  Iris prolapse covered by conjunctiva GRANULOMA  After surgical wound (squint or pterygium surgery)  Site of foreign body  Treatment – surgical excision
  • 24.
  • 26.  Triangular yellow patch on nasal limbus  Occurs in elderly  Hyaline infiltration with elastotic degeneration of subconjunctival tissue  Treatment – excision for cosmetic purposes
  • 27.
  • 28.  Triangular sheet of fibrovascular tissue invading cornea  Occurs after recurrence  Treatment – excision and auto conjunctival transplantation
  • 29.
  • 30.  Silvery white, foamy or cheesy patch  Keratinised epithelium – temporal limbus  Seen in vitamin A deficiency
  • 31.
  • 32.  Papilloma  Intraepithelial epithelioma  Squamous cell carcinoma  Primary melanoma
  • 33.  Benign polypoid tumour  Sessile/peduncle  Can become malignant  Treatment: surgical excision
  • 34. SQUAMOUS CELL CARCINOMA  Flat granular growth  Invades underlying structures  Requires early excision
  • 35.
  • 36.  Nodular form, may be pigmented or non-pigmented  Treatment - excision
  • 37.
  • 38.  Intercalary or ciliary staphyloma  Filtering bleb – following trabeculectomy  Parasitic cyst – cysticercosis  Retention cyst
  • 39.
  • 40.  Bulge in limbal area  Lined by root of iris due to ectasia of weak scar tissue  Following healed perforation injuries or corneal ulcer
  • 41.
  • 42.  Thin walled cyst with clear fluid  Excision indicated if there is irritation or foreign body sensation or for cosmetic purposes