Nodule at the limbus

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

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

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

12. SCLERITIS–
Nodular or diffuse form
Nodule is fixed to sclera
Pain and uveitis
Causes– collagen
disorders,Endogenous infections.
Treatment: steroids

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

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

19. Granulomatous inflammation
to caterpillar hair
Treatment: steroid or excision

21. Benign red lesion which blanches
on pressure
Bleeds on trivial trauma
May be associated with
hemangioma
of lid and orbit

23. Granuloma
Implantation cyst
Iris prolapse covered by conjunctiva
GRANULOMA
After surgical wound (squint or pterygium
surgery)
Site of foreign body
Treatment – surgical excision

25. Pingecula
Cystic pterygium

26. Triangular yellow patch on nasal
limbus
Occurs in elderly
Hyaline infiltration with elastotic
degeneration of subconjunctival
tissue
Treatment – excision for cosmetic
purposes

28. Triangular sheet of fibrovascular
tissue invading cornea
Occurs after recurrence
Treatment – excision and auto
conjunctival transplantation

30. Silvery white, foamy or cheesy
patch
Keratinised epithelium –
temporal limbus
Seen in vitamin A deficiency

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

36. Nodular form, may be
pigmented or non-pigmented
Treatment - excision

38. Intercalary or ciliary
staphyloma
Filtering bleb – following
trabeculectomy
Parasitic cyst – cysticercosis
Retention cyst

40. Bulge in limbal area
Lined by root of iris due to ectasia
of weak scar tissue
Following healed perforation
injuries or corneal ulcer

42. Thin walled cyst with clear fluid
Excision indicated if there is
irritation or foreign body sensation
or for cosmetic purposes